Individual
MADISON MALOOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7979 N SHADELAND AVE STE 310, INDIANAPOLIS, IN 46250-2042
(317) 621-3970
(317) 621-3087
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003439A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300057167
—
IN
Enumeration date
06/08/2021
Last updated
07/16/2025
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