Individual
DR. SAM EDWARD MANSOUR
Active
Individual
DR. SAM EDWARD MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101233782
VA
207W00000X
Ophthalmology Physician
A49545
CA
207W00000X
Ophthalmology Physician
D0059626
MD
207W00000X
Ophthalmology Physician
MD 34095
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010107024
—
VA
05
—
010107067
—
VA
05
—
037331500
—
DC
01
—
143213
BLUE CROSS BLUE SHIELD
VA
Enumeration date
04/07/2006
Last updated
04/11/2025
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