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General NPI Number Information
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NPI Number | 1780850560
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Entity Type | Organization
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Legal Business Name | SARMAD AL-MANSOUR, MD, PC
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 22972 LAHSER RD
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City | SOUTHFIELD
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State | MI
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Zip | 48033
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Country | US
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Telephone | 248-353-4777
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Fax | 248-353-4235
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Provider Business Mailing Address
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Address Line | 8889 LAMONT
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City | LIVONIA
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State | MI
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Zip | 48150
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Country | US
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Telephone | 248-353-4777
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Fax | 248-353-4235
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARMAD J AL-MANSOUR
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Credential | M.D.
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Telephone | 248-353-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | SA053934
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License Number State | MI
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