# KINGSWOOD INTERNAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780806810
- **Authorized official:** FAIZ MANSOUOR (PARTNER)
- **Authorized official phone:** (248) 334-3136

## Contact information

- **Practice address:** 43097 WOODWARD AVE, SUITE 204, BLOOMFIELD HILLS, MI 48302-5041
- **Practice address phone:** (248) 334-3136
- **Practice address fax:** (248) 334-3871
- **Mailing address:** 43097 WOODWARD AVE, SUITE 204, BLOOMFIELD HILLS, MI 48302-5041
- **Mailing address phone:** (248) 334-3136
- **Mailing address fax:** (248) 334-3871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 10/11/2007