Diana Marie Madison PA

NPI 1083600332 - Physician Assistant - 363A00000X

NPI Details
NPI 1083600332
Gender Female
Enumeration Date 09/22/2005
Last Updated 12/20/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
1381 UNIVERSITY ST
HEALDSBURG CA, 95448-3314, US
Phone (707) 431-8234
Fax (707) 431-1427
Business Location
1381 UNIVERSITY ST
HEALDSBURG CA, 95448-3314, US
Phone (707) 431-8234
Fax
Toxanomy
Taxonomy Code 363A00000X
License State California
License Number PA12122
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According to our database, Diana Marie Madison PA NPI is 1083600332, taxonomy code is 363A00000X and license number is PA12122, license state is located at California. Diana Marie Madison PA physically located at 1381 University St, Healdsburg CA, 95448-3314. NPI Number Diana Marie Madison PA has the Individual type.

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1083600332 NPI number is provided on an as is basis without warranty of any kind. 1083600332 is maintained by the National Plan & Provider Enumeration System. The contents of Diana Marie Madison PA are for informational purposes only.