MEDICARE: DR. ERNEST JOHN MADARANG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	37458	AZ

General Provider Information

NPI Number	:	1083690978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST JOHN MADARANG M.D.

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	DEPARTMENT OF RADIOLOGY
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-2937
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	DEPARTMENT OF RADIOLOGY
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-2937
Country	:	US
Telephone Number	:	913-588-6875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	04/05/2011

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