Provider Demographics
NPI:1952757031
Name:MATHKOUR, MANSOUR H (MD)
Entity type:Individual
Prefix:DR
First Name:MANSOUR
Middle Name:H
Last Name:MATHKOUR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:LPG NEUROSURGERY
Mailing Address - Street 2:593 EDDY STREET, , RI 02903
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-793-9166
Mailing Address - Fax:401-444-2788
Practice Address - Street 1:LPG NEUROSURGERY
Practice Address - Street 2:593 EDDY STREET, , RI 02903
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-793-9166
Practice Address - Fax:401-444-2788
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2024-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD19363207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery