Individual
OWEN MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 PARKER HILL AVE, ROXBURY CROSSING, MA 02120-2847
(617) 754-6687
Mailing address
PO BOX 9135, ATT:SHARON SILVA, BROOKLINE, MA 02446-9135
(800) 927-0002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207995
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136191
—
MA
Enumeration date
09/19/2005
Last updated
01/06/2015
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