Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 75716 | MA |
Y | 208200000X | Surgeon | 75716 | MA |
Y | 208600000X | Surgeon | 75716 | MA |
NPI | 1699765743 |
---|---|
Provider Name | Dr. Robert L Madden |
First Address | Ludlow, MA 01056-0366 |
Second Address | West Springfield, MA 01089-1353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 13/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003087881 | (05) | CT |
3093832 | (05) | MA |
E11198 | (02) |