MEDICARE: MADISON ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1023066743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADISON ASSOCIATES PC

Provider Business Mailing Address
First Line	:	3410 E 12 MILE RD
Second Line	:	SUITE C
City	:	WARREN
State	:	MI
Zip	:	48092-2593
Country	:	US
Telephone Number	:	810-751-7733
Fax Number	:

Provider Business Practice Location Address
First Line	:	3410 E 12 MILE RD
Second Line	:	SUITE C
City	:	WARREN
State	:	MI
Zip	:	48092-2593
Country	:	US
Telephone Number	:	810-751-7733
Fax Number	:

Authorized Official
Title or Position	:	MANAGING AGENT/OWNER
Name	:	JEAN SINKOFF
Credential	:	MD
Telephone Number	:	810-751-7733

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

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