MEDICARE: DAVID R MANDEL M.D.

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
1	207RR0500X	Rheumatology Physician	35-042685-M	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558369553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID R MANDEL M.D.

Provider Business Mailing Address
First Line	:	6551 WILSON MILLS RD
Second Line	:	#106
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-3495
Country	:	US
Telephone Number	:	440-449-8277
Fax Number	:	440-449-7137

Provider Business Practice Location Address
First Line	:	6551 WILSON MILLS RD
Second Line	:	#106
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-3495
Country	:	US
Telephone Number	:	440-449-8277
Fax Number	:	440-449-7137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/08/2007

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Directions to “ DAVID R MANDEL M.D.” Practice Location

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