Individual
MICHAEL CAMERON MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1013 N LACROSSE ST APT A10, RAPID CITY, SD 57701-6959
(925) 565-3169
Mailing address
1013 N LACROSSE ST APT A10, RAPID CITY, SD 57701-6959
(925) 565-3169
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95198315
CA
Other
Enumeration date
08/16/2020
Last updated
05/05/2025
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