Provider Demographics
NPI:1093715344
Name:MADDEN, MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13221 RAVENNA RD STE 12
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9016
Mailing Address - Country:US
Mailing Address - Phone:440-285-7874
Mailing Address - Fax:440-285-7875
Practice Address - Street 1:13170 RAVENNA RD
Practice Address - Street 2:SUITE 108
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-7025
Practice Address - Country:US
Practice Address - Phone:440-285-7874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-9647M208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery