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General NPI Number Information
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NPI Number | 1598903528
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Entity Type | Organization
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Legal Business Name | CAROLINA PULMONARY & SLEEP DISORDER, LLC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 109 FLEETWOOD DR SUITE C
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City | EASLEY
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State | SC
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Zip | 29640-2019
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Country | US
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Telephone | 864-850-0700
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Fax | 864-850-0705
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Provider Business Mailing Address
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Address Line | 68 GLOBAL DR SUITE 100
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City | GREENVILLE
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State | SC
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Zip | 29607-4628
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Country | US
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Telephone | 864-644-2700
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Fax | 864-644-2709
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Authorized Official
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Title or Position | MD
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Name | DR. ABBAS MANSOUR
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Credential | MD
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Telephone | 864-850-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 26847
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License Number State | SC
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