Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 3728 | AZ |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 3728 | AZ |
NPI | 1386643567 |
---|---|
Provider Name | Dr. David B Mendelson |
First Address | Phoenix, AZ 85006-2606 |
Second Address | Tempe, AZ 85281-5676 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 10/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
698251 | (05) | AZ |
E54243 | (02) | AZ |