Doctor Name: | MOHAMED MANSOUR |
NPI Number: | 1790938868 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301092330 |
Business Practice Address: | G3230 Beecher Rd Flint, MI - 485323604 |
Business Phone Number: | 4076203003 |
Business Fax Number: | 8104713094 |
Mailing Address: | Po Box 4085, FLINT |
State: | MI |
Postal Code: | 485040085 |
Phone Number: | 4076203003 |
Fax Number: | 8104713094 |
NPI Enumeration Date: | 11/03/2008 |
NPI Last Update Date: | 05/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301092330 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |