Individual
PETER G MANDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1030 PRESIDENT AVE, SUITE 3001, FALL RIVER, MA 02720-5923
(508) 973-9700
(508) 674-7378
Mailing address
200 MILL RD, SUITE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
59233
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110045550A
—
MA
05
—
PM08447
—
RI
Enumeration date
06/02/2006
Last updated
04/22/2020
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