Individual
SAMUEL DAVID MANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-1000
Mailing address
PO BOX 1707, MILLEDGEVILLE, GA 31059-1707
(478) 457-2036
(478) 457-2042
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
018523
GA
207L00000X
Anesthesiology Physician
Primary
18523
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00229578E
—
GA
01
—
050082957
MEDICARE RAILROAD
GA
Enumeration date
02/13/2006
Last updated
10/24/2022
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