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Individual

DR. ALAY MANSUROV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
908 W 4TH NORTH ST, MORRISTOWN, TN 37814-3894
(423) 492-6100
Mailing address
908 W 4TH NORTH ST, MORRISTOWN, TN 37814-3894
(423) 492-6100

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.067089
IL
207RH0003X
Hematology & Oncology Physician
Primary
72453-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
389016
AMERICAN BOARD OF INTERNAL MEDICINE/HEMATOLOGY AND ONCOLOGY
05
Q043373
TN
Enumeration date
07/08/2015
Last updated
12/02/2024
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