Provider Demographics
NPI:1932961943
Name:MANSUR, JIHAD A SR
Entity Type:Individual
Prefix:
First Name:JIHAD
Middle Name:A
Last Name:MANSUR
Suffix:SR
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 1:1451 BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-3205
Mailing Address - Country:US
Mailing Address - Phone:614-378-8814
Mailing Address - Fax:
Practice Address - Street 1:1451 BARNETT RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-3205
Practice Address - Country:US
Practice Address - Phone:614-378-8814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty