Provider Demographics
NPI:1659342384
Name:MANSOURI, VAFA CYRUS (DO)
Entity type:Individual
Prefix:DR
First Name:VAFA
Middle Name:CYRUS
Last Name:MANSOURI
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 WALLACE RD STE 414
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8010
Mailing Address - Country:US
Mailing Address - Phone:615-284-7260
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:397 WALLACE RD STE 414
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8010
Practice Address - Country:US
Practice Address - Phone:615-333-0851
Practice Address - Fax:615-333-0852
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1875207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6011968OtherBCBS
TNP01376528OtherRR MEDICARE
TN33000062Medicaid
TNP01376528OtherRR MEDICARE
TN103I067965Medicare PIN