Provider Demographics
NPI:1063487247
Name:MALADKAR, MADAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:MADAN
Middle Name:A
Last Name:MALADKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4100 GOSS ROAD
Mailing Address - Street 2:FOX ARMY HEALTH CENTER, CREDENTIALS CO-ORDINATOR
Mailing Address - City:REDSTONE ARSENAL
Mailing Address - State:AL
Mailing Address - Zip Code:35809-7000
Mailing Address - Country:US
Mailing Address - Phone:256-955-8888
Mailing Address - Fax:256-313-6734
Practice Address - Street 1:4100 GOSS ROAD
Practice Address - Street 2:FOX ARMY HEALTH CENTER, PRIMARY CARE CLINIC
Practice Address - City:REDSTONE ARSENAL
Practice Address - State:AL
Practice Address - Zip Code:35809-7000
Practice Address - Country:US
Practice Address - Phone:256-955-8888
Practice Address - Fax:256-313-6734
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL25045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine