Individual
MR. ASIFHUSEN ABDULRAHIM MANSURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-7701
(706) 721-8623
Mailing address
1499 WALTON WAY STE 1400, AUGUSTA, GA 30901-2603
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
080136
GA
390200000X
Student in an Organized Health Care Education/Training Program
BP10048201
TX
Other
Enumeration date
08/27/2013
Last updated
05/07/2018
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