Provider Demographics
NPI:1417900945
Name:SALDIVAR, MADELAINE RAMOS (MD)
Entity Type:Individual
Prefix:
First Name:MADELAINE
Middle Name:RAMOS
Last Name:SALDIVAR
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 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 330 MOB WEST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-645-6555
Mailing Address - Fax:610-649-4744
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 330 MOB WEST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-645-6555
Practice Address - Fax:610-649-4744
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426462207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG75437Medicare UPIN
PA101454397Medicaid
PA097944HK1Medicare PIN