Individual
DR. MOUHAMAD MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601
(218) 333-5000
(218) 333-4961
Mailing address
PO BOX 2010, FARGO, ND 58122-2484
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301094037
MI
207RC0000X
Cardiovascular Disease Physician
Primary
63889
MN
207RC0000X
Cardiovascular Disease Physician
MD60541420
WA
Other
Enumeration date
08/13/2009
Last updated
09/18/2018
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