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Individual

MADONNA A. BIRITWUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 848-4150
(360) 848-4169
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
01070155A
IN
207RI0200X
Infectious Disease Physician
Primary
MD60748436
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2088459
WA
Enumeration date
02/24/2009
Last updated
10/25/2021
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