MANSOUR MERCY MEDICAL CENTER PLLC NPI 1699852343

NPI Information

  • NPI: 1699852343
  • Provider Name: MANSOUR MERCY MEDICAL CENTER PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 23D0370284
  • Address: 21321 KELLY RD STE 100
    EASTPOINTE, MI
    ZIP 48021
  • Phone: (586) 443-5580

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NPI Details

MANSOUR MERCY MEDICAL CENTER PLLC is a family medicine in Eastpointe, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MANSOUR MERCY MEDICAL CENTER PLLC NPI is 1699852343. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21321 KELLY RD STE 100
EASTPOINTE, MI
ZIP 48021-214
Phone: (586) 443-5580
Fax: (586) 443-5590

The provider's authorized official is Alaa G Mansour .
The authorized official title is Presadent and has the following contact phone number (586) 443-5580.

The CLIA number assigned to this NPI record is 23D0370284 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 10/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineAM078660MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11105015892OTHERMICHIGANBCBS
24717292MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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