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General NPI Number Information
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NPI Number | 1316403876
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Entity Type | Individual
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Provider Name | MICHAEL CONRAD MADEJ FNP
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Gender | Male
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 03/16/2019
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Provider Practice Location Address
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Address Line | 4125 MEDINA RD STE 200B
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City | AKRON
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State | OH
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Zip | 44333-4514
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Country | US
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Telephone | 330-344-1255
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Fax |
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Provider Business Mailing Address
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Address Line | 5998 E WALLINGS RD
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City | BROADVIEW HTS
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State | OH
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Zip | 44147-1536
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Country | US
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Telephone | 440-539-5636
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.024421
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License Number State | OH
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