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NPI Code Detail

MEDICARE: DAVID MADEWELL

MEDICARE: DAVID MADEWELL
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
1122300000XDentist122300000XKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285000562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MADEWELL
Provider Business Mailing Address
First Line : 1044 ALTA VISTA RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-1758
Country : US
Telephone Number : 270-315-6690
Fax Number :
Provider Business Practice Location Address
First Line : 1044 ALTA VISTA RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-1758
Country : US
Telephone Number : 270-315-6690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2015
Last Update Date : 08/20/2015

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Directions to “ DAVID MADEWELL ” Practice Location

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