Provider Demographics
NPI:1972034072
Name:ASSAAD, MANSUR
Entity Type:Individual
Prefix:
First Name:MANSUR
Middle Name:
Last Name:ASSAAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ARCH ST STE 501
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1434
Mailing Address - Country:US
Mailing Address - Phone:330-319-9700
Mailing Address - Fax:234-312-2368
Practice Address - Street 1:75 ARCH ST STE 501
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1434
Practice Address - Country:US
Practice Address - Phone:330-319-9700
Practice Address - Fax:234-312-2368
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.147332207RC0200X, 207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program