Individual
DR. DERALD L. MADSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3964 FRAZEYSBURG RD, ZANESVILLE, OH 43701-8924
(740) 455-4944
(740) 450-6199
Mailing address
3964 FRAZEYSBURG RD, ZANESVILLE, OH 43701-8924
(740) 455-4944
(740) 450-6199
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
35059388
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122822
ANTHEM
OH
05
—
2131955
—
OH
01
—
311661239026
CARESOURCE
OH
Enumeration date
06/13/2005
Last updated
04/02/2013
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