Provider Demographics
NPI:1720029663
Name:MADU, ERNEST C (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:C
Last Name:MADU
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 1:211 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1801
Mailing Address - Country:US
Mailing Address - Phone:615-340-3430
Mailing Address - Fax:615-340-0274
Practice Address - Street 1:211 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1801
Practice Address - Country:US
Practice Address - Phone:615-340-3430
Practice Address - Fax:615-340-0274
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25931207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F13560Medicare UPIN
3086071Medicare ID - Type Unspecified