MEDICARE: DAVID L MADISON 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
1	2086S0129X	Vascular Surgery Physician	01031866A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	760000004	OTHER		RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000083157	OTHER		BCBS PIN

General Provider Information

NPI Number	:	1851326011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L MADISON MD

Provider Business Mailing Address
First Line	:	4880 CENTURY PLAZA RD
Second Line	:	# 905
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5469
Country	:	US
Telephone Number	:	317-279-6314
Fax Number	:	317-947-2698

Provider Business Practice Location Address
First Line	:	4880 CENTURY PLAZA RD
Second Line	:	# 905
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5469
Country	:	US
Telephone Number	:	317-279-6314
Fax Number	:	317-947-2698

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	09/04/2017

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Directions to “ DAVID L MADISON MD” Practice Location

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