Individual
MICHAEL F YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19251 MACK AVE, GROSSE POINTE WOODS, MI 48236-2893
(313) 343-7280
(313) 343-7921
Mailing address
19251 MACK AVE, SUITE 333, GROSSE POINTE WOODS, MI 48236-2893
(313) 343-7280
(313) 343-7921
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301067942
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0Q262160
BLUE CROSS GROUP
MI
05
—
4106213
—
MI
01
—
4301067942
CONTROLLED SUBSTANCE
—
Enumeration date
08/31/2005
Last updated
07/18/2008
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