Provider Demographics
NPI:1881630978
Name:MENDLOW, STEPHANIE (M D)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:MENDLOW
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 SUNSET LN STE 102
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3914
Mailing Address - Country:US
Mailing Address - Phone:540-829-4374
Mailing Address - Fax:540-829-4178
Practice Address - Street 1:545 SUNSET LN STE 102
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3914
Practice Address - Country:US
Practice Address - Phone:540-829-4374
Practice Address - Fax:540-829-4178
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039420207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010030323Medicaid
VA437751OtherBCBS #
P00089798Medicare PIN
VAA37113Medicare UPIN
00V644B66Medicare PIN