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Individual

DR. MADISON MCCULLOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3600 MINNESOTA DR STE 800, EDINA, MN 55435-7915
(952) 595-1100
(612) 294-4903
Mailing address
3600 MINNESOTA DR STE 800, EDINA, MN 55435-7915
(952) 595-1100
(612) 294-4903

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-12463
ID
2085R0202X
Diagnostic Radiology Physician
Primary
MD60424508
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0325620
LNI-RADIA REST OF WA COUNTIES
WA
01
0325621
LNI-SWEDISH RADIA EDMONDS
WA
01
0325622
LNIEVERGREEN RADIA
WA
01
0327385
LNI-RADIA KING COUNTY
WA
01
0385244
LNI-SOUTH SOUND
WA
05
1114124690
ID
05
1114124690
WA
05
2035053
WA
Enumeration date
06/28/2007
Last updated
02/05/2026
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