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General NPI Number Information
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NPI Number | 1760618987
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Entity Type | Organization
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Legal Business Name | NON-INVASIVE COSMETICS LTD
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 14300 GALLANT FOX LN SUITE 203
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City | BOWIE
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State | MD
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Zip | 20715-4003
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Country | US
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Telephone | 301-262-6363
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Fax | 301-805-8700
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Provider Business Mailing Address
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Address Line | 14300 GALLANT FOX LN STE 203
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City | BOWIE
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State | MD
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Zip | 20715-4033
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Country | US
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Telephone | 301-262-6363
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Fax | 301-805-8700
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANSOUR G. PANAH
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Credential | M.D.
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Telephone | 301-262-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D15506
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License Number State | MD
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