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NPI 1780838433

NPI 1780838433 : CATHERINE MADSEN O.D. : BELTSVILLE, MD

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General NPI Number Information
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    NPI Number           |    1780838433
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    Entity Type          |    Individual 
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    Provider Name        |    CATHERINE MADSEN O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/07/2008
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    Last Update Date     |    11/07/2008
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Provider Practice Location Address
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    Address Line         |    10925 BALTIMORE AVE 
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    City                 |    BELTSVILLE
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    State                |    MD
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    Zip                  |    20705-2117
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    Country              |    US
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    Telephone            |    301-595-5959
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4208 SHERIDAN ST 
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    City                 |    UNIVERSITY PARK
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    State                |    MD
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    Zip                  |    20782-2137
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    Country              |    US
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    Telephone            |    301-919-2694
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    TA 1607
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    License Number State |    MD
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