Individual
DR. ISSAM NABEEH MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
38525 8 MILE RD, LIVONIA, MI 48152-1012
(248) 888-9504
Mailing address
39445 NORTHWIND CT, NORTHVILLE, MI 48167-3932
(248) 888-9500
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
590100217
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
5901002177
MI
Other
Enumeration date
03/26/2007
Last updated
11/09/2012
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