Provider Demographics
NPI:1417927435
Name:RENDLEMAN, DAVID ATWELL III (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ATWELL
Last Name:RENDLEMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:321 CAMBRIDGE WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1036
Mailing Address - Country:US
Mailing Address - Phone:919-781-2496
Mailing Address - Fax:
Practice Address - Street 1:3410 EXECUTIVE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7450
Practice Address - Country:US
Practice Address - Phone:919-872-5296
Practice Address - Fax:919-850-9718
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16932207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8971261Medicaid
NCC86132Medicare UPIN
NC201800Medicare ID - Type Unspecified