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NPI Code Detail

MEDICARE: RAGHAV MADAN MD

MEDICARE: RAGHAV MADAN 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
1390200000XStudent in an Organized Health Care Education/Training Program
2208800000XUrology PhysicianME174838FL

General Provider Information

NPI Number : 1881273217
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAGHAV MADAN MD
Provider Business Mailing Address
First Line : 25020 HADLOCK DR
Second Line :
City : NOVI
State : MI
Zip : 48374-2553
Country : US
Telephone Number : 248-787-6691
Fax Number :
Provider Business Practice Location Address
First Line : 3990 JOHN R ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2018
Country : US
Telephone Number : 248-787-6691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2021
Last Update Date : 03/04/2026

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Directions to “ RAGHAV MADAN MD” Practice Location

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