Individual
MR. MICHAEL A MANDELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
37650 PROFESSIONAL CENTER DRIVE, STE 125A, LIVONIA, MI 48154
(734) 462-1197
(734) 462-1496
Mailing address
37650 PROFESSIONAL CENTER DRIVE, STE 125A, LIVONIA, MI 48154
(734) 462-1197
(734) 462-1496
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
057959
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OM06390
BCBS
MI
Enumeration date
05/22/2006
Last updated
07/08/2007
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