# NICHOLAS MADAFFER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649535824
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 252846 | MA | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 2017012404 | MO | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | 4665-850 | WI | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2017012404 | MO | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 301480 | LA | — |

## Other

- **Enumeration date:** 07/12/2012
- **Last updated:** 11/14/2024