Provider Demographics
NPI:1326015231
Name:MAGADIA, RAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:MAGADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 GILES ST
Mailing Address - Street 2:
Mailing Address - City:HEFLIN
Mailing Address - State:AL
Mailing Address - Zip Code:36264-1738
Mailing Address - Country:US
Mailing Address - Phone:256-237-2351
Mailing Address - Fax:256-237-2350
Practice Address - Street 1:1112 CHRISTINE AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4658
Practice Address - Country:US
Practice Address - Phone:256-237-2351
Practice Address - Fax:256-237-2350
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26338207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1104891241OtherGROUP NPI
ALDB8444OtherRAILROAD GROUP NUMBER
AL009981505Medicaid
ALP00219363OtherRAILROAD MEDICARE ID
AL051526130Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
AL009981505Medicaid