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NPI Code Detail

MEDICARE: DR. NDIDI EUGENE MADU D.O.

MEDICARE: DR. NDIDI EUGENE MADU D.O.
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
1207Q00000XFamily Medicine Physician065703GA
2207Q00000XFamily Medicine Physician65703GA

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 : 1457587842
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NDIDI EUGENE MADU D.O.
Provider Business Mailing Address
First Line : 49 LAFAYETTE RD UNIT C
Second Line :
City : HAMPTON FALLS
State : NH
Zip : 03844-2326
Country : US
Telephone Number : 770-929-0404
Fax Number : 603-912-8394
Provider Business Practice Location Address
First Line : 11720 AMBER PARK DR STE 160
Second Line :
City : ALPHARETTA
State : GA
Zip : 30009-2271
Country : US
Telephone Number : 855-232-7888
Fax Number : 603-912-8394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2009
Last Update Date : 01/13/2026

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