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NPI Code Detail

MEDICARE: SALAH ELDEIN MANSOUR PA-C

MEDICARE: SALAH ELDEIN MANSOUR PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601008360MI

General Provider Information

NPI Number : 1427567569
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALAH ELDEIN MANSOUR PA-C
Provider Business Mailing Address
First Line : 142 E MAUMEE ST STE 3
Second Line :
City : ADRIAN
State : MI
Zip : 49221-2735
Country : US
Telephone Number : 313-213-9433
Fax Number :
Provider Business Practice Location Address
First Line : 142 E MAUMEE ST STE 3
Second Line :
City : ADRIAN
State : MI
Zip : 49221-2735
Country : US
Telephone Number : 313-388-1666
Fax Number : 313-388-6961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2017
Last Update Date : 01/22/2026

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Directions to “ SALAH ELDEIN MANSOUR PA-C” Practice Location

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