Provider Demographics
NPI:1386633477
Name:MADAN, MICHAEL P (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:MADAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 PLEASANT STREET
Mailing Address - Street 2:CAPITAL REGION FAMILY
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-228-7200
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:250 PLEASANT STREET
Practice Address - Street 2:CAPITAL REGION FAMILY
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-228-7200
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2013-07-15
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Provider Licenses
StateLicense IDTaxonomies
NH13596207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4158828OtherMRP
NHG35240OtherHARVARE PILGRIM
NH3073313Medicaid
NH01YP12076NH01OtherANTHEM
VT1018111Medicaid
NH22-2594672OtherUNITED HEALTHCARE
NH22-2594672OtherMARTIN POINT
NH4906674OtherCIGNA
NH30206977Medicaid
NH3073313Medicaid
NH30206977Medicaid
NH4158828OtherMRP