Healthcare Provider Details

I. General information

NPI: 1770686636
Provider Name (Legal Business Name): JAMES MALCOLM MADSEN MD, MPH, FCAP, FACOE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 RICKETTS POINT RD USAMRICD, ATTN: MCMR-CDM (COL MADSEN)
GUNPOWDER MD
21010-5400
US

IV. Provider business mailing address

527 INGLEWOOD RD
BEL AIR MD
21015-2005
US

V. Phone/Fax

Practice location:
  • Phone: 410-436-2230
  • Fax: 410-436-3086
Mailing address:
  • Phone: 410-836-8754
  • Fax: 410-436-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number177428-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number177428-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: