Organization
MICHIGANS PREMIER FOOT AND ANKLE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAA MANSOUR DPM (SOLE MEMBER)
(630) 808-9939
Entity
Organization
Contact information
Practice address
17000 EXECUTIVE PLAZA DR STE 101, DEARBORN, MI 48126-2793
(313) 565-4948
(313) 565-4989
Mailing address
5861 DEEPWOOD CT, CLARKSTON, MI 48346-3168
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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