Individual
DR. SHAUN DOUGLAS MENDENHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-2208
(215) 590-2496
Mailing address
30 N 1900 E RM 6152, SALT LAKE CITY, UT 84132-0002
(801) 581-7719
(801) 581-5797
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
10742767-1205
UT
208200000X
Plastic Surgery Physician
Primary
MD460847
PA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
10742767-1205
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
10742767-1205
UT
Other
Enumeration date
06/29/2011
Last updated
11/29/2021
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