1144214255 NPI number — DR. ALVIN SERRANO MADARANG M.D.

Table of content: DR. ALVIN SERRANO MADARANG M.D. (NPI 1144214255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144214255 NPI number — DR. ALVIN SERRANO MADARANG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MADARANG
Provider First Name:
ALVIN
Provider Middle Name:
SERRANO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144214255
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10907 LAMPLIGHTER LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTOMAC
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20854-2782
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-765-0907
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1406 CRAIN HWY S
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-4058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-590-4141
Provider Business Practice Location Address Fax Number:
410-590-4159
Provider Enumeration Date:
09/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0039166 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com