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General NPI Number Information
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NPI Number | 1295746121
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Entity Type | Individual
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Provider Name | JAMES D MADISON MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 13367 ISLE DR
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City | BAXTER
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State | MN
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Zip | 56425-2221
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Country | US
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Telephone | 218-855-5280
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 23058
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License Number State | MN
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