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NPI Code Detail

MEDICARE: MADISON KOCHER WULFECK MD

MEDICARE: MADISON KOCHER WULFECK 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
12085R0202XDiagnostic Radiology Physician308820NC
22085R0202XDiagnostic Radiology Physician92863GA
3208600000XSurgery PhysicianLL41098SC
42085R0202XDiagnostic Radiology PhysicianME154441FL

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 : 1750801031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON KOCHER WULFECK MD
Provider Business Mailing Address
First Line : 1801 SUNSET DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-6803
Country : US
Telephone Number : 803-434-4166
Fax Number : 803-434-4183
Provider Business Practice Location Address
First Line : 5000 W OAKLAND PARK BLVD
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33313-1503
Country : US
Telephone Number : 954-735-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2017
Last Update Date : 01/26/2026

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