Individual
JACOB MANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
680 CENTRE ST, BROCKTON HOSPITAL, BROCKTON, MA 02302-3308
(508) 941-7150
Mailing address
680 CENTRE ST, BROCKTON HOSPITAL, BROCKTON, MA 02302-3308
(508) 941-7150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L-236085
MA
2085R0202X
Diagnostic Radiology Physician
Primary
245910
MA
Other
Enumeration date
06/09/2008
Last updated
10/06/2014
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