Provider Demographics
NPI:1831290618
Name:MEHNE, DAVID KARL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KARL
Last Name:MEHNE
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:EDIFCIO PROFESIONAL MENONITA
Mailing Address - Street 2:SUITE 306
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705
Mailing Address - Country:US
Mailing Address - Phone:787-735-0333
Mailing Address - Fax:787-735-0220
Practice Address - Street 1:EDIFCIO PROFECIONAL MENONITA
Practice Address - Street 2:SUITE 306
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-0333
Practice Address - Fax:787-735-0220
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7608207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B55479Medicare UPIN
99249Medicare ID - Type Unspecified