Provider Demographics
NPI:1902812258
Name:MEHL, DAVID C (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:MEHL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 EDWARD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2823
Mailing Address - Country:US
Mailing Address - Phone:516-569-8541
Mailing Address - Fax:
Practice Address - Street 1:6310 108TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1355
Practice Address - Country:US
Practice Address - Phone:718-896-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004175213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01256459Medicaid
NYP07932OtherMEDICARE BCBS
NY01256459Medicaid
NY81883Medicare PIN