Advanced Foot & Ankle Care Center 2 PLLC
Podiatrist, Foot & Ankle Surgery in Royal Oak, MI. Organization (NPI-2).
NPI number1922275478
StatusActive
Last updated in NPPESMay 14, 2008
Details
- NPI
- 1922275478
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Foot & Ankle Care Center 2 PLLC
- Organization subpart
- No
- Enumeration date
- May 14, 2008
- Last updated
- May 14, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 5901002177 | MI | Yes |
Other names
- Issam N. Mansour Dpm (Other Name)
Practice location
5130 Coolidge HwyC/O Royal Oak Medical Center
Royal Oak, MI 48073-1001
Phone 248-288-9500 · Fax 248-288-0044
Mailing address
24230 Karim BlvdSte #140
Novi, MI 48375-2953
Phone 248-888-9500 · Fax 248-888-9504
Authorized official
Issam N Mansour
Owner/Podiatrist
2488889500
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