Provider Demographics
NPI:1811632227
Name:YUSUF, AISHA AMBREEN (DO)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:AMBREEN
Last Name:YUSUF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:615-706-8357
Mailing Address - Fax:
Practice Address - Street 1:4220 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-1808
Practice Address - Country:US
Practice Address - Phone:623-281-1258
Practice Address - Fax:480-906-2175
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ011270207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program