Provider Demographics
NPI:1952788085
Name:MADAN, AVNEET (MD)
Entity Type:Individual
Prefix:
First Name:AVNEET
Middle Name:
Last Name:MADAN
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 1:4830 SOUTHPOINT DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2606
Mailing Address - Country:US
Mailing Address - Phone:540-370-4468
Mailing Address - Fax:
Practice Address - Street 1:4830 SOUTHPOINT DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2606
Practice Address - Country:US
Practice Address - Phone:540-370-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA109163002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry