Provider Demographics
NPI:1710528492
Name:MENDY S MACCABEE MD CONSULTANT LLC
Entity Type:Organization
Organization Name:MENDY S MACCABEE MD CONSULTANT LLC
Other - Org Name:MENDY S MACCABEE MD CONSULTANT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MACCABEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-706-9965
Mailing Address - Street 1:1790 MAY ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1369
Mailing Address - Country:US
Mailing Address - Phone:541-436-3880
Mailing Address - Fax:541-436-3881
Practice Address - Street 1:1790 MAY ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1369
Practice Address - Country:US
Practice Address - Phone:541-436-3880
Practice Address - Fax:541-436-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty