Provider Demographics
NPI:1508984873
Name:MADRAZO, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:MADRAZO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:600 N WOLFE STREET
Practice Address - Street 2:CARNEGIE 565
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-8315
Practice Address - Fax:410-367-2151
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-03-30
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Provider Licenses
StateLicense IDTaxonomies
MO2005012336207RC0000X
MDD77178207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease