Individual
DR. IRVIN R MADURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6014 OLD BRANCH AVE, KAISER PERMANENTE CAMP SPRINGS MEDICAL CENTER, TEMPLE HILLS, MD 20748-2518
(301) 702-6100
(301) 702-6366
Mailing address
2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W, KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
D0038713
MD
152WP0200X
Pediatric Optometrist
MD22166
DC
Other
Enumeration date
12/12/2006
Last updated
01/07/2022
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