Provider Demographics
NPI:1497079024
Name:MENDELSOHN, CRAIG BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BRIAN
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 1:4450 S PARK AVE
Mailing Address - Street 2:SUITE 1709
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3621
Mailing Address - Country:US
Mailing Address - Phone:202-256-5160
Mailing Address - Fax:
Practice Address - Street 1:4450 S PARK AVE
Practice Address - Street 2:SUITE 1709
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3621
Practice Address - Country:US
Practice Address - Phone:202-256-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30416207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology