Organization
PAUL D MANDEL MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL D MANDEL M.D. (PRESIDENT/OWNER)
(414) 224-7686
Entity
Organization
Contact information
Practice address
5150 N PORT WASHINGTON RD, SUITE 167, GLENDALE, WI 53217-5474
(414) 224-7686
(414) 224-7685
Mailing address
5150 N PORT WASHINGTON RD, SUITE 167, GLENDALE, WI 53217-5474
(414) 224-7686
(414) 224-7685
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23817
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30592500
—
WI
Enumeration date
10/12/2006
Last updated
11/11/2008
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