Individual
DR. MICHAEL MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
10715
MS
207RC0000X
Cardiovascular Disease Physician
44178
AL
207RI0011X
Interventional Cardiology Physician
Primary
44178
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118990
—
MS
01
—
060048938
MEDICARE RAILROAD
MS
01
—
134987001
MEDICAID OF ARKANSAS
—
Enumeration date
07/03/2006
Last updated
08/13/2026
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