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NPI Code Detail

MEDICARE: DR. MANSOUR S ISCKARUS M.D.

MEDICARE: DR. MANSOUR S ISCKARUS M.D.
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
1207RH0003XHematology & Oncology Physician35094671OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2H283592OTHEROHMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770581787
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANSOUR S ISCKARUS M.D.
Provider Business Mailing Address
First Line : 1761 BEALL AVE STE 1
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2342
Country : US
Telephone Number : 330-262-2800
Fax Number : 330-262-2807
Provider Business Practice Location Address
First Line : 1761 BEALL AVE STE 1
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2342
Country : US
Telephone Number : 330-262-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 11/23/2020

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