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NPI Code Detail

MEDICARE: MADELAINE MICHELE HADDICAN MD

MEDICARE: MADELAINE MICHELE HADDICAN 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
1207N00000XDermatology Physician35.142642OH

General Provider Information

NPI Number : 1891062857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELAINE MICHELE HADDICAN MD
Provider Business Mailing Address
First Line : 14601 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-4205
Country : US
Telephone Number : 216-237-5500
Fax Number : 216-636-5956
Provider Business Practice Location Address
First Line : 14601 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-4205
Country : US
Telephone Number : 216-237-5500
Fax Number : 216-636-5956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2011
Last Update Date : 07/06/2021

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