Provider Demographics
NPI:1972940336
Name:MADHANI, DHANVANT J (MD)
Entity Type:Individual
Prefix:DR
First Name:DHANVANT
Middle Name:J
Last Name:MADHANI
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 1:2614 EVERGREEN POINT RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:WA
Mailing Address - Zip Code:98039-1527
Mailing Address - Country:US
Mailing Address - Phone:206-234-4915
Mailing Address - Fax:
Practice Address - Street 1:2614 EVERGREEN POINT RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:WA
Practice Address - Zip Code:98039-1527
Practice Address - Country:US
Practice Address - Phone:206-234-4915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-25
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00011804207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery