Individual
PROF. VICTOR MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36175 HARPER AVE, CLINTON TOWNSHIP, MI 48035-3274
(586) 741-3772
(586) 741-4604
Mailing address
36175 HARPER AVE, CLINTON TOWNSHIP, MI 48035-3274
(586) 741-3772
(586) 741-4604
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
4301043142
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301043142
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0Q26008
BCBS PROVIDER NUMBER
MI
01
—
0Q26008
BLUE CARE NETWORK
—
01
—
1006439
MCCLAREN HEALTH
—
05
—
4856349
—
MI
01
—
Q26008059
RR MEDICARE
—
Enumeration date
05/01/2006
Last updated
10/25/2007
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