Donald James Maddack DO

NPI 1013911031 - General Practice - 208D00000X

NPI Details
NPI 1013911031
Gender Male
Enumeration Date 06/08/2005
Last Updated 03/19/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
3125 WILLOWCREEK RD
PORTAGE IN, 46368-4423, US
Phone (219) 762-3175
Fax (219) 763-3092
Business Location
3125 WILLOWCREEK RD
PORTAGE IN, 46368-4423, US
Phone (219) 762-3175
Fax (219) 763-3092
Toxanomy
Taxonomy Code 208D00000X
License State Indiana
License Number 02001180
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According to our database, Donald James Maddack DO NPI is 1013911031, taxonomy code is 208D00000X and license number is 02001180, license state is located at Indiana. Donald James Maddack DO physically located at 3125 Willowcreek Rd, Portage IN, 46368-4423. NPI Number Donald James Maddack DO has the Individual type.

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1013911031 NPI number is provided on an as is basis without warranty of any kind. 1013911031 is maintained by the National Plan & Provider Enumeration System. The contents of Donald James Maddack DO are for informational purposes only.