Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Roozbeh Mansour, MD

Individual provider Surgery Physician · NPI 1063745388

Roozbeh Mansour, MD is a General Surgery in Detroit, Michigan. Qualified in 2004, 22 years ago. Practices with University Physician Group, a 402-clinician group and accepts Medicare assignment. Licensed in Indiana and Michigan.

Years since qualifying
22
Licensed in
IN, MI
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4160 John R St Ste 615
Detroit, MI 48201-2022
Phone: (313) 745-8773
Fax: (313) 993-0595
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 4301092120 (MI)
Surgery Physician Taxonomy 208600000X · Licence 01076835A (IN)

Record details

NPI number1063745388
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 18, 2009
Last updated in NPPESApril 18, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice University Physician Group — 402 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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