Individual
MICHAEL D. MANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5855 BREMO RD, STE 403, RICHMOND, VA 23226-1930
(804) 288-3079
(804) 282-6159
Mailing address
5855 BREMO RD, STE 403, RICHMOND, VA 23226-1930
(804) 288-3079
(804) 282-6159
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101024952
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6057128
—
VA
01
—
C06778
GROUP PTAN
VA
Enumeration date
05/18/2006
Last updated
03/11/2011
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