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Individual

DR. NELSON TAN MADRAZO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
103 GA HIGHWAY 27 E, AMERICUS, GA 31709-3800
(229) 924-8082
(229) 924-8009
Mailing address
132 DOGWOOD HILLS RD, AMERICUS, GA 31709-5304

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
49862
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000905165D
GA
05
000905165E
GA
Enumeration date
06/04/2006
Last updated
10/03/2013
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