Provider Demographics
NPI:1104984046
Name:MANTELL, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:MANTELL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 416147
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6147
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:484-924-0053
Practice Address - Street 1:51 N. 39TH STREET
Practice Address - Street 2:HEART & VASCULAR PAVILION 4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:215-662-9551
Practice Address - Fax:215-243-3225
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2025-06-13
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Provider Licenses
StateLicense IDTaxonomies
PAMD047966L2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery