Healthcare Provider Details

I. General information

NPI: 1750295101
Provider Name (Legal Business Name): MADISON ELIZABETH DYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 402
BLAND VA
24315-0402
US

IV. Provider business mailing address

PO BOX 402
BLAND VA
24315-0402
US

V. Phone/Fax

Practice location:
  • Phone: 276-920-7273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: