Individual
WALEED MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.DL
Contact information
Practice address
1397 S CANFIELD NILES RD, UNIT 1, AUSTINTOWN, OH 44515-4084
(330) 953-0129
(330) 953-0650
Mailing address
1397 S CANFIELD NILES RD, UNIT 1, AUSTINTOWN, OH 44515-4084
(330) 953-0129
(330) 953-0650
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35078230M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181396874-0001
PENNSYLVANIA MEDICAID
OH
05
—
2254180
—
OH
01
—
P00164262
RAILROAD MEDICARE
OH
Enumeration date
12/16/2005
Last updated
11/30/2016
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