Individual
NICHOLAS MADAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-2700
(573) 815-3693
Mailing address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-2700
(573) 815-3693
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
252846
MA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2017012404
MO
208100000X
Physical Medicine & Rehabilitation Physician
4665-850
WI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
2017012404
MO
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
301480
LA
Other
Enumeration date
07/12/2012
Last updated
11/14/2024
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