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General NPI Number Information
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NPI Number | 1184014102
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Entity Type | Individual
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Provider Name | MANSOOR AHMAD MD
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Gender | Male
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD
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City | NEWARK
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State | DE
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Zip | 19718-0001
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Country | US
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Telephone | 302-733-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 5849 BROAD BRANCH WAY
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City | FREDERICK
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State | MD
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Zip | 21704-6701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C7-0005994
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57.021825
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | D87100
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License Number State | MD
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