Provider Demographics
NPI:1972505196
Name:MANDEL, SHELDON R (MD)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:R
Last Name:MANDEL
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 1:3414 OLANDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1384
Mailing Address - Country:US
Mailing Address - Phone:301-774-0500
Mailing Address - Fax:301-774-1186
Practice Address - Street 1:3414 OLANDWOOD CT
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1384
Practice Address - Country:US
Practice Address - Phone:301-774-0500
Practice Address - Fax:301-774-1186
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19012207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C61482Medicare UPIN
MD579L914CMedicare PIN
DC012432P56Medicare PIN
DC012432P53Medicare PIN
MD376M520FMedicare PIN