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Individual
DR. MADHAVI MADUGULA
Active
Individual
DR. MADHAVI MADUGULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301085702
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121987
—
IL
05
—
4769673
—
MI
01
—
833120
MEDICARE GROUP
IL
01
—
CA2264
RR GROUP #
—
01
—
P00690231
RR MEDICARE INDIVIDUAL #
—
Enumeration date
06/20/2006
Last updated
12/17/2021
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