MEDICARE: NAIM MADYUN

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
1	103TS0200X	School Psychologist	1001784289	MD

General Provider Information

NPI Number	:	1720968282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAIM MADYUN

Provider Business Mailing Address
First Line	:	8909 RIGGS RD
Second Line	:
City	:	ADELPHI
State	:	MD
Zip	:	20783-1633
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8909 RIGGS RD
Second Line	:
City	:	ADELPHI
State	:	MD
Zip	:	20783-1633
Country	:	US
Telephone Number	:	571-322-6173
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2025
Last Update Date	:	09/05/2025

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Directions to “ NAIM MADYUN ” Practice Location

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