Provider Demographics
NPI:1023325438
Name:MENDELSON ORTHOPEDICS PC
Entity type:Organization
Organization Name:MENDELSON ORTHOPEDICS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-261-1960
Mailing Address - Street 1:500 STEPHENSON HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1118
Mailing Address - Country:US
Mailing Address - Phone:586-439-6258
Mailing Address - Fax:
Practice Address - Street 1:13488 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1366
Practice Address - Country:US
Practice Address - Phone:586-439-6243
Practice Address - Fax:586-439-6240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENDELSON ORTHOPEDICS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-07
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL7568632251X0800X
MIL11373822251X0800X
MIL11815072251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty