Provider Demographics
NPI:1548494529
Name:MOZAYAN, MANSOOR (MD)
Entity type:Individual
Prefix:
First Name:MANSOOR
Middle Name:
Last Name:MOZAYAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9105 FRANKLIN SQUARE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3958
Mailing Address - Country:US
Mailing Address - Phone:410-574-1330
Mailing Address - Fax:410-574-2691
Practice Address - Street 1:9105 FRANKLIN SQUARE DR STE 209
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3958
Practice Address - Country:US
Practice Address - Phone:410-574-1330
Practice Address - Fax:410-574-2691
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2015-07-26
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Provider Licenses
StateLicense IDTaxonomies
MDD0079563207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology