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NPI Code Detail

MEDICARE: MICHAEL MADRID MD

MEDICARE: MICHAEL MADRID MD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician81283CT

General Provider Information

NPI Number : 1275160079
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MADRID MD
Provider Business Mailing Address
First Line : 3614 ALAMO AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-2010
Country : US
Telephone Number : 208-921-9271
Fax Number :
Provider Business Practice Location Address
First Line : 111 COLCHESTER AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-1473
Country : US
Telephone Number : 802-847-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2020
Last Update Date : 01/08/2026

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