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Individual
BANEE MADISON
Active
Individual
BANEE MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200759
LA
Other
Enumeration date
10/01/2014
Last updated
11/05/2014
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