Individual
DR. MARC P. MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
541 MAIN ST, SUITE 210, SOUTH WEYMOUTH, MA 02190-1868
(781) 952-1280
(781) 952-1570
Mailing address
541 MAIN ST, SUITE 210, SOUTH WEYMOUTH, MA 02190-1868
(781) 952-1280
(781) 952-1570
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
74727
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074727
TUFTS HEALTH PLAN
MA
05
—
3107051
—
MA
01
—
61619
HARVARD PILGRIM
MA
01
—
J13523
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/29/2005
Last updated
03/13/2014
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