Individual
DR. RAMIL MANSOUROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 MAIN ST, NORWALK, CT 06851-2720
(203) 644-4775
(203) 547-6118
Mailing address
235 MAIN ST, NORWALK, CT 06851-2720
(203) 644-4775
(203) 547-6118
Taxonomy
Speciality
Code
Description
License number
State
193200000X
Multi-Specialty Group
Primary
040028
CT
207P00000X
Emergency Medicine Physician
44050
KY
207Q00000X
Family Medicine Physician
9376
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12543
—
ND
01
—
26162
BCBS
ND
Enumeration date
04/07/2006
Last updated
06/21/2016
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