Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2021-01570 | NC |
N | 207XS0117X | Orthopaedic Spine Surgeon | 45364 | CO |
NPI | 1043430911 |
---|---|
Provider Name | Michael Wayne Madsen |
First Address | Durham, NC 27704-2150 |
Second Address | Smithfield, NC 27577-9444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I36041 | (02) |