MEDICARE: DR. MADISON COLYN CUFFY MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208600000X	Surgery Physician	35099637	OH
3	204F00000X	Transplant Surgery Physician	35099637	OH

General Provider Information

NPI Number	:	1134395254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADISON COLYN CUFFY MD

Provider Business Mailing Address
First Line	:	PO BOX 636256 CENTRAL CREDENTIALING
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-6256
Country	:	US
Telephone Number	:	513-585-5506
Fax Number	:	513-585-5511

Provider Business Practice Location Address
First Line	:	231 ALBERT SABIN WAY
Second Line	:	ML 0558, DEPT. OF SURGERY
City	:	CINCINNATI
State	:	OH
Zip	:	45267-2827
Country	:	US
Telephone Number	:	513-475-8787
Fax Number	:	513-475-7348

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

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	03/12/2018

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