Provider Demographics
NPI:1376252106
Name:MENDELSON ORTHOPEDICS PC
Entity Type:Organization
Organization Name:MENDELSON ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:MENDELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-261-1960
Mailing Address - Street 1:500 STEPHENSON HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1118
Mailing Address - Country:US
Mailing Address - Phone:586-439-6258
Mailing Address - Fax:
Practice Address - Street 1:11900 E 12 MILE RD STE 110
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3487
Practice Address - Country:US
Practice Address - Phone:586-261-1960
Practice Address - Fax:586-261-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site