# MAZEN MADHOUN MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679904338
- **Authorized official:** DR. MAZEN MADHOUN MD (OWNER)
- **Authorized official phone:** (540) 397-5319

## Contact information

- **Practice address:** 6002 WINNBROOK LN, ROANOKE, VA 24018-7907
- **Practice address phone:** (540) 397-5319
- **Practice address fax:** (540) 947-3142
- **Mailing address:** 6002 WINNBROOK LN, ROANOKE, VA 24018-7907
- **Mailing address phone:** (540) 397-5319
- **Mailing address fax:** (540) 947-3142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101247995 | VA | Yes |

## Other

- **Enumeration date:** 12/06/2013
- **Last updated:** 03/06/2023