Provider Demographics
NPI:1679529325
Name:RENDEK, STEPHEN MARTIN III (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MARTIN
Last Name:RENDEK
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3894 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1140
Mailing Address - Country:US
Mailing Address - Phone:614-238-1111
Mailing Address - Fax:614-238-9151
Practice Address - Street 1:3894 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-1140
Practice Address - Country:US
Practice Address - Phone:614-238-1111
Practice Address - Fax:614-238-9151
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor