Provider Demographics
NPI:1013809003
Name:ELWAGHAF, YOUSSOUF
Entity type:Individual
Prefix:
First Name:YOUSSOUF
Middle Name:
Last Name:ELWAGHAF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5322 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-5932
Mailing Address - Country:US
Mailing Address - Phone:812-581-0093
Mailing Address - Fax:
Practice Address - Street 1:5322 NOTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-5932
Practice Address - Country:US
Practice Address - Phone:812-581-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN9370508646343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)