Provider Demographics
NPI:1932091196
Name:MENDLIFE MD LLC
Entity type:Organization
Organization Name:MENDLIFE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-418-6060
Mailing Address - Street 1:9920 FRANKLIN SQUARE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4985
Mailing Address - Country:US
Mailing Address - Phone:410-653-4002
Mailing Address - Fax:225-666-0803
Practice Address - Street 1:9920 FRANKLIN SQUARE DR STE 220
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4985
Practice Address - Country:US
Practice Address - Phone:410-653-4002
Practice Address - Fax:225-666-0803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty