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Organization
MICHIGANS PREMIER FOOT AND ANKLE PLLC
Active
Organization
MICHIGANS PREMIER FOOT AND ANKLE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAA MANSOUR DPM (SOLE MEMBER)
(630) 808-9939
Entity
Organization
Contact information
Practice address
17000 EXECUTIVE PLAZA DR STE 101, DEARBORN, MI 48126-2793
(313) 565-4948
(313) 565-4989
Mailing address
5861 DEEPWOOD CT, CLARKSTON, MI 48346-3168
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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