Individual
DR. ALAA G MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21321 KELLY RD STE 100, EASTPOINTE, MI 48021-3214
(586) 443-5580
(586) 443-5590
Mailing address
21321 KELLY RD STE 100, EASTPOINTE, MI 48021-3214
(586) 443-5580
(586) 443-5590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AM078660
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029259
MIDWEST MEDICAID
MI
01
—
1105015892
BLUE CARE NETWORK
MI
01
—
12852
CAPE HEALTH PLAN
MI
01
—
139818
CARE CHOICES
MI
01
—
149966
GREAT LAKES HEALTH PLAN
MI
01
—
16928
MCARE
MI
05
—
4717292
—
MI
01
—
I21667
HAP
MI
01
—
P00304762
RAILROAD MEDICARE
MI
Enumeration date
10/24/2005
Last updated
08/11/2025
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