Healthcare Provider Details
I. General information
NPI: 1770302267
Provider Name (Legal Business Name): MENDLIFE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9920 FRANKLIN SQUARE DR STE 220
NOTTINGHAM MD
21236-4985
US
IV. Provider business mailing address
9920 FRANKLIN SQUARE DR STE 220
NOTTINGHAM MD
21236-4985
US
V. Phone/Fax
- Phone: 410-653-4002
- Fax:
- Phone: 410-653-4002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MAX
BRODSKY
Title or Position: OWNER
Credential: MD
Phone: 443-418-6060