Provider Demographics
NPI:1336278738
Name:MENDEL, LAWRENCE HAROLD (DO)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:HAROLD
Last Name:MENDEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 AUDRA CT
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6101
Mailing Address - Country:US
Mailing Address - Phone:614-471-8151
Mailing Address - Fax:419-735-5445
Practice Address - Street 1:1050 FREEWAY DR N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5430
Practice Address - Country:US
Practice Address - Phone:614-752-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine