Imad Mansoor MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301407249 Issued in MI

Legal business name

IMAD MANSOOR MD, PC

Practice address

42557 Woodward Ave Ste 110
Bloomfield Hills, MI 48304-5206

Phone

(248) 333-1170

NPI assigned

Oct 11, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Imad Mansoor, MDNPI 1699883082

Title

President

Phone

(248) 840-4312

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Imad M Mansoor, MD

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1699883082
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1821548181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42557 WOODWARD AVE STE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045206",
            "telephone_number": "248-333-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42557 WOODWARD AVE STE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045206",
            "telephone_number": "248-333-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAD MANSOOR MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "MANSOOR",
        "authorized_official_first_name": "IMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-840-4312",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301407249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.