Provider Demographics
NPI:1548989635
Name:MENDENHALL, STEVE (REPT)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:MENDENHALL
Suffix:
Gender:M
Credentials:REPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8655 E VIA DE VENTURA STE E155
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3354
Mailing Address - Country:US
Mailing Address - Phone:480-596-1686
Mailing Address - Fax:480-483-8455
Practice Address - Street 1:8655 E VIA DE VENTURA STE E155
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3354
Practice Address - Country:US
Practice Address - Phone:480-596-1686
Practice Address - Fax:480-483-8455
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1104246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic