Provider Demographics
NPI:1366023582
Name:MANSOUR, MONICA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:MARIE
Last Name:MANSOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:MARIE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7301 E 2ND ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5620
Mailing Address - Country:US
Mailing Address - Phone:480-587-5890
Mailing Address - Fax:
Practice Address - Street 1:7301 E 2ND ST STE 210
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5620
Practice Address - Country:US
Practice Address - Phone:480-882-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program