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General NPI Number Information
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NPI Number | 1255593646
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Entity Type | Individual
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Provider Name | BITA MANSOURI MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 2145 MOUNT PLEASANT BLVD SE
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City | ROANOKE
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State | VA
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Zip | 24014
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Country | US
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Telephone | 540-427-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CORPORATE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70508-3870
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Country | US
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Telephone | 800-893-9698
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD61682674
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 116020786
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101249669
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 26298
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101249669
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License Number State | VA
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