Provider Demographics
NPI:1982676326
Name:MADDEN, MICHAEL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:MADDEN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:120 5TH AVE
Mailing Address - Street 2:STE FAP733
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3000
Mailing Address - Country:US
Mailing Address - Phone:412-544-7014
Mailing Address - Fax:412-544-6792
Practice Address - Street 1:120 5TH AVE
Practice Address - Street 2:STE FAP733
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3000
Practice Address - Country:US
Practice Address - Phone:412-544-7014
Practice Address - Fax:412-544-6792
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD025071E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30356Medicare UPIN