Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 01073435A | IN |
N | 207QA0505X | Family Doctor - Adult Medicine | 4301106566 | MI |
N | 207U00000X | Nuclear Medicine Specialist | 01073435A | IN |
NPI | 1396928552 |
---|---|
Provider Name | Dr. Sheraz Younus |
First Address | Saint Joseph, MI 49085-2112 |
Second Address | Saint Joseph, MI 49085-2112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2007 |
Last Update Date | 07/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201204710 | (05) | IN |
261970070 | MEDICARE PTAN (01) | IN |