Healthcare Provider Details

I. General information

NPI: 1730097817
Provider Name (Legal Business Name): PIERRE MENDY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 CEDAR LN
COLUMBIA MD
21044-2912
US

IV. Provider business mailing address

120 FLOWER CENTER LN
GAITHERSBURG MD
20878-2294
US

V. Phone/Fax

Practice location:
  • Phone: 410-740-7890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number0136001038
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: