Individual
FAIZ MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10 W SQUARE LAKE RD STE 202, BLOOMFIELD HILLS, MI 48302-0467
(248) 452-9500
(248) 253-0443
Mailing address
10 W SQUARE LAKE RD STE 202, BLOOMFIELD HILLS, MI 48302-0467
(248) 452-9500
(248) 253-0443
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301059179
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0636377
BCBSM
MI
01
—
383552831
COMMERCIAL
MI
05
—
4255901
—
MI
Enumeration date
08/27/2006
Last updated
07/31/2008
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