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NPI Code Detail

MEDICARE: MADISON MEDICAL CENTER

MEDICARE: MADISON MEDICAL CENTER
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
1261QM1300XMulti-Specialty Clinic/CenterMI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P32225FOTHERMIBCN

General Provider Information

NPI Number : 1033115548
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADISON MEDICAL CENTER
Provider Business Mailing Address
First Line : 30781 STEPHENSON HWY
Second Line :
City : MADISON HTS
State : MI
Zip : 48071-1618
Country : US
Telephone Number : 248-583-8922
Fax Number : 248-583-8969
Provider Business Practice Location Address
First Line : 13409 E 14 MILE RD
Second Line :
City : STERLING HTS
State : MI
Zip : 48312-6304
Country : US
Telephone Number : 586-977-3900
Fax Number : 586-977-6084
Authorized Official
Title or Position : PRESIDENT
Name : RAM GUNABALAN
Credential : MD
Telephone Number : 248-583-8922
Provider Enumeration Date : 06/21/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

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Practice Location Address:
13409 E 14 MILE RD
STERLING HTS, MI
48312-6304
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1790781656 — ROGER S YIM DO
Practice Location Address:
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STERLING HEIGHTS, MI
48312-6304
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Practice Fax: 586-977-6084
1275767592 — STERLING MEDICAL CLINIC PLLC
Practice Location Address:
13439 E 14 MILE RD
STERLING HEIGHTS, MI
48312-6304
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1356678544 — STERLING MEDICAL CLINIC PLLC
Practice Location Address:
13439 E 14 MILE RD
STERLING HEIGHTS, MI
48312-6304
Practice Phone: 586-977-3900
Practice Fax: 586-977-6084

Directions to “MADISON MEDICAL CENTER ” Practice Location

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