Provider Demographics
NPI:1073318812
Name:ALMANSOUR, YASSER
Entity type:Individual
Prefix:
First Name:YASSER
Middle Name:
Last Name:ALMANSOUR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7072 WOODS WEST DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-9463
Mailing Address - Country:US
Mailing Address - Phone:810-965-1484
Mailing Address - Fax:
Practice Address - Street 1:7072 WOODS WEST DR
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-9463
Practice Address - Country:US
Practice Address - Phone:810-965-1484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program