Individual
DR. GEORGE MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11040 SANDISTAN DR, SAINT LOUIS, MO 63146-5583
(402) 208-2254
Mailing address
11040 SANDISTAN DR, SAINT LOUIS, MO 63146-5583
(402) 208-2254
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2015021633
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
08/13/2012
Last updated
04/18/2023
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