Mansour, Sam Edward

Mansour, Sam Edward is an individual health care provider with primary practice located at 20 Rock Pointe Lane Suite 201, Warrenton VA 20186. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mansour, Sam Edward can be contacted via phone (703) 443-0015.

Contact Information

Primary practice address
20 Rock Pointe Lane Suite 201 Warrenton VA 20186
Phone: (703) 443-0015
Fax: (703) 738-7157
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101233782 Virginia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X D0059626 Maryland
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD 34095 District of Columbia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X A49545 California

Profile Details

NPI number 1376506873
LBN Legal business name Mansour, Sam Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Sep 6th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376506873 NPPES
Virginia MEDICAID 010107067
Virginia MEDICAID 010107024
Virginia MEDICAID 037331500
Virginia Other 143213

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