Individual
MANDAL BRIAN HAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 TRUMP RD NW, CARROLLTON, OH 44615-8422
(330) 627-7055
(330) 627-7602
Mailing address
1020 TRUMP RD NW, P.O. BOX 38, CARROLLTON, OH 44615-8422
(330) 739-5402
(330) 627-7602
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35070993H
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019916
—
OH
Enumeration date
08/09/2006
Last updated
07/08/2007
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