Dr. Alay Mansurov
Internist Hematology & Oncology
1580 Commanche Ave
Green Bay
, Wisconsin 54313-5751
Dr. Alay Mansurov
Internist Hematology & Oncology
1580 Commanche Ave
Green Bay
, Wisconsin 54313-5751
(920) 445-7289
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About
Features
Specialties
- Internist
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Dr. Alay Mansurov
- Po Box 22487
- Green Bay, WI
- Zip : 54305-2487
- Fax : (920) 445-7289
- Phone : (920) 445-7222
Second Address
- Dr. Alay Mansurov
- 1580 Commanche Ave
- Green Bay, WI
- Zip : 54313-5751
- Fax : (920) 430-4659
- Phone : (920) 435-8326
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Is Dr. Alay Mansurov a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 125.067089 | IL |
| N | 111NI0900X | Internist | 125.067089 | IL |
| Y | 207RH0003X | Hematology & Oncology | 72453-20 | WI |
National Provider Identifier
| NPI | 1033592035 |
|---|---|
| Provider Name | Dr. Alay Mansurov |
| First Address | Green Bay, WI 54305-2487 |
| Second Address | Green Bay, WI 54313-5751 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/07/2015 |
| Last Update Date | 26/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 389016 | AMERICAN BOARD OF INTERNAL MEDICINE/HEMATOLOGY AND ONCOLOGY (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.