Individual
MICHAEL JAMES MADURA
Active
Individual
MICHAEL JAMES MADURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301043486
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004100351
BCBS OF MICHIGAN
MI
05
—
3318794
—
MI
01
—
38-2145264
IRS TAX ID# THRU CORP
—
Enumeration date
08/24/2006
Last updated
06/22/2010
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