Individual
DANIEL E MADDELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(260) 373-8000
(260) 373-8034
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01075977A
IN
2084P0800X
Psychiatry Physician
MD00032406
WA
Other
Enumeration date
01/02/2007
Last updated
10/07/2022
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