Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD027327L | PA |
NPI | 1003898644 |
---|---|
Provider Name | Morton S Mandell |
First Address | Philadelphia, PA 19141-3046 |
Second Address | Philadelphia, PA 19141-3046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 02/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006543720003 | (05) | PA |
C26996 | (02) |