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General NPI Number Information
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NPI Number | 1386616134
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Entity Type | Individual
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Provider Name | MAHER MONIR MANSOUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 3200 W MARKET ST STE 205
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City | FAIRLAWN
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State | OH
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Zip | 44333-3335
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Country | US
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Telephone | 330-836-6825
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Fax | 330-836-6742
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Provider Business Mailing Address
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Address Line | 2644 MIDDLETON RD
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City | HUDSON
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State | OH
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Zip | 44236-1512
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Country | US
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Telephone | 330-342-1140
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Fax | 330-836-6742
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35061917M
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License Number State | OH
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