Healthcare Provider Details

I. General information

NPI: 1700239415
Provider Name (Legal Business Name): MENDELSON ORTHOPEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5504 E 12 MILE RD STE 200
WARREN MI
48092-4637
US

IV. Provider business mailing address

5504 E 12 MILE RD STE 200
WARREN MI
48092-4637
US

V. Phone/Fax

Practice location:
  • Phone: 586-261-1960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID MENDELSON
Title or Position: PHYSICIAN/PRESIDENT
Credential: MD
Phone: 586-439-6258