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NPI Code Detail

MEDICARE: ERIC THOMAS MENDENHALL MD

MEDICARE: ERIC THOMAS MENDENHALL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080N0001XNeonatal-Perinatal Medicine Physician2023-02325NC
2208000000XPediatrics Physician2023-02325NC

General Provider Information

NPI Number : 1245850734
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC THOMAS MENDENHALL MD
Provider Business Mailing Address
First Line : PO BOX 751069
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1069
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 252-847-4378
Fax Number : 252-847-9943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2020
Last Update Date : 06/26/2026

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