Provider Demographics
NPI:1508904822
Name:RENDLEMAN, NOEL IVAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:IVAN
Last Name:RENDLEMAN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19991 HALL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4254
Mailing Address - Country:US
Mailing Address - Phone:586-263-4401
Mailing Address - Fax:586-263-4402
Practice Address - Street 1:19991 HALL RD STE 102
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4254
Practice Address - Country:US
Practice Address - Phone:586-263-4401
Practice Address - Fax:586-263-4402
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000013231HA2400X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter