Provider Demographics
NPI:1760521413
Name:MADHAV, HARISHCHANDER THAWERDAS (MD, MPH, FACOG)
Entity Type:Individual
Prefix:DR
First Name:HARISHCHANDER
Middle Name:THAWERDAS
Last Name:MADHAV
Suffix:
Gender:M
Credentials:MD, MPH, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 SE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7206
Mailing Address - Country:US
Mailing Address - Phone:561-738-1100
Mailing Address - Fax:
Practice Address - Street 1:2226 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7206
Practice Address - Country:US
Practice Address - Phone:561-738-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044918207V00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055935100Medicaid
10746BMedicare PIN
E55282Medicare UPIN