Organization
SARMAD AL-MANSOUR, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARMAD J AL-MANSOUR M.D. (OWNER)
(248) 353-4777
Entity
Organization
Contact information
Practice address
22972 LAHSER RD, SOUTHFIELD, MI 48033
(248) 353-4777
(248) 353-4235
Mailing address
8889 LAMONT, LIVONIA, MI 48150
(248) 353-4777
(248) 353-4235
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
SA053934
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106356921
MICHIGAN BCBS
MI
05
—
4926846
—
MI
05
—
4931882
—
MI
Enumeration date
05/01/2008
Last updated
09/18/2008
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