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Individual

JOSEPH MANSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 963-0166
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01085090A
IN
390200000X
Student in an Organized Health Care Education/Training Program
2015018568
MO

Other

Enumeration date
06/28/2015
Last updated
01/11/2022
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