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NPI Code Detail

MEDICARE: DAWN KELLY MADISON

MEDICARE: DAWN KELLY MADISON
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
1104100000XSocial Worker
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1245857341
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN KELLY MADISON
Provider Business Mailing Address
First Line : 25701 N LAKELAND BLVD STE 403
Second Line :
City : EUCLID
State : OH
Zip : 44132-2453
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25701 N LAKELAND BLVD STE 403
Second Line :
City : EUCLID
State : OH
Zip : 44132-2453
Country : US
Telephone Number : 216-273-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2020
Last Update Date : 12/29/2022

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Directions to “ DAWN KELLY MADISON ” Practice Location

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