Individual
MADISON ELIZABETH HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
3601 W 13 MILE RD OFC, ROYAL OAK, MI 48073-6712
(248) 551-6498
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4351049605
MI
208000000X
Pediatrics Physician
4351049605
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4351049605
STATE MEDICAL LICENSE
MI
Enumeration date
06/07/2022
Last updated
06/07/2022
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