Provider Demographics
NPI:1265511034
Name:MIDATHADA, MADHU V (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHU
Middle Name:V
Last Name:MIDATHADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4004 PIONEER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7548
Mailing Address - Country:US
Mailing Address - Phone:402-484-4900
Mailing Address - Fax:402-484-6456
Practice Address - Street 1:4004 PIONEER WOODS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7548
Practice Address - Country:US
Practice Address - Phone:402-484-4900
Practice Address - Fax:402-484-6456
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE23290207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I30684Medicare UPIN