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Individual

DR. CORY KANE MANSOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3625 BRASELTON HWY STE 201, DACULA, GA 30019-4695
(678) 889-2326
Mailing address
1364 CLIFTON RD NE # T5L38, ATLANTA, GA 30322-1059

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
81919
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
81919
GA

Other

Enumeration date
05/02/2014
Last updated
07/08/2021
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