Individual
DR. MICHAEL MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 SPRING HILL AVE STE 100, MOBILE, AL 36604-1416
(251) 435-1200
(251) 435-6357
Mailing address
1700 SPRING HILL AVE STE 100, MOBILE, AL 36604-1416
(251) 435-1200
(251) 435-6357
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
10715
MS
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
06/08/2022
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