Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD-48947 | IA |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | R-11611 | IA |
N | 207RC0000X | Internist - Cardiovascular Disease | 31062 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | 68538 | MN |
Y | 207RC0000X | Internist - Cardiovascular Disease | MD-48947 | IA |
NPI | 1063068732 |
---|---|
Provider Name | Shareef Mansour |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2019 |
Last Update Date | 09/12/2021 |