Individual
AYA HASEEB MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
340 KENNESTONE HOSPITAL BLVD STE 100, MARIETTA, GA 30060-1158
(770) 281-5100
(678) 581-7100
Mailing address
1114 SUNNY FIELD LN, LAWRENCEVILLE, GA 30043-6703
(678) 266-7445
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
09/25/2023
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