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General NPI Number Information
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NPI Number | 1417679192
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Entity Type | Individual
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Provider Name | NACIME SALOMAO BARBACHAN MANSUR MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 3333 N CALVERT ST
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City | BALTIMORE
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State | MD
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Zip | 21218-2867
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Country | US
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Telephone | 410-554-6844
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 CLEARFIELD CIR
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City | TIMONIUM
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State | MD
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Zip | 21093-4707
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Country | US
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Telephone | 319-400-7911
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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 | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | T-1185
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License Number State | IA
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