Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME73473 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME73473 | FL |
NPI | 1184730004 |
---|---|
Provider Name | Dr. David M. Mandel |
First Address | Rockland, DE 19732-0191 |
Second Address | Jacksonville, FL 32207-8426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 23/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000752727A | (05) | GA |
1414107 | (05) | LA |
252624700 | (05) | FL |
G64748 | (02) |