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General NPI Number Information
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NPI Number | 1457563926
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Entity Type | Organization
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Legal Business Name | ERIC S MENDELSOHN DPM PC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 21500 NORTHWESTERN HWY NORTHLAND CENTER, SUITE 636
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5018
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Country | US
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Telephone | 248-569-1395
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Fax | 248-623-1697
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Provider Business Mailing Address
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Address Line | 21500 NORTHWESTERN HWY NORTHLAND CENTER, SUITE 636
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5018
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Country | US
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Telephone | 248-569-1395
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Fax | 248-623-1697
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC STEVEN MENDELSOHN
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Credential | DPM
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Telephone | 248-569-1395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | EM000833
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | EM000833
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License Number State | MI
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