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Individual

DR. MATTHEW JACOB MADER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9245 MAIN ST, KANSAS CITY, MO 64114-3640
(479) 619-8963
Mailing address
9245 MAIN ST, KANSAS CITY, MO 64114-3640
(479) 619-8963

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
76872-20
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/06/2017
Last updated
07/07/2023
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