Provider Demographics
NPI:1275801896
Name:MENDELSOHN, GEORGE EMANUEL (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:EMANUEL
Last Name:MENDELSOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LOREN WOODS
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1903
Mailing Address - Country:US
Mailing Address - Phone:314-991-0247
Mailing Address - Fax:314-991-5567
Practice Address - Street 1:24 LOREN WOODS
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1903
Practice Address - Country:US
Practice Address - Phone:314-991-0247
Practice Address - Fax:314-991-5567
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3359207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery