Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35-07-3072-M | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35-07-3072-M | OH |
NPI | 1245248558 |
---|---|
Provider Name | Dr. Irwin Michael Mandel |
First Address | Westlake, OH 44145-2526 |
Second Address | Westlake, OH 44145-2526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 26/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2316916 | (05) | OH |
H60112 | (02) | OH |