Individual
DR. IAN THOMAS MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
130 S BRYN MAWR AVE, BRYN MAWR, PA 19010-3121
(484) 337-3000
Mailing address
130 S BRYN MAWR AVE, BRYN MAWR, PA 19010-3121
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
OT021449
PA
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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