Individual
JEFFREY D. MENDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11900 E 12 MILE RD, SUITE 110, WARREN, MI 48093-3400
(586) 582-7070
(586) 572-7066
Mailing address
11900 E 12 MILE RD, SUITE 110, WARREN, MI 48093-3400
(586) 582-7070
(586) 572-7066
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301054943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200E011770
BCBS GROUP NUMBER
MI
05
—
3226253
—
MI
Enumeration date
10/24/2005
Last updated
10/22/2008
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