Individual
MADISON MAIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 727-5658
Mailing address
4501 NE 55TH ST, SEATTLE, WA 98105-2937
(206) 307-7582
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16018
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2024
Last updated
05/05/2024
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