Individual
ROBERT DAVID MADOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455
(612) 672-7422
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
25693
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013003
PREFERRED ONE
—
05
—
0075089
—
MT
05
—
0582528
—
IA
01
—
100426
UCARE
—
01
—
14-00004
MEDICA PRIMARY
—
01
—
14-00074
MEDICA CHOICE
—
01
—
24924
ARAZ
—
05
—
31621700
—
WI
01
—
564R3MA
BLUE CROSS BLUE SHIELD
MN
05
—
841062300
—
MN
01
—
HP13891
HEALTH PARTNERS
—
Enumeration date
10/20/2006
Last updated
07/23/2018
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