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Individual

AHED MANSOURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
(706) 238-8086
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
048170
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000862199B
GA
Enumeration date
12/15/2006
Last updated
04/27/2020
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