Individual
MICHAEL T MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6200
(952) 883-9677
Mailing address
2355 HWY 36 W., STE. 100, ROSEVILLE, MN 55113
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
32412
MN
2085R0202X
Diagnostic Radiology Physician
32412
MN
2085R0204X
Vascular & Interventional Radiology Physician
32412
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189307600
—
MN
Enumeration date
01/10/2006
Last updated
02/04/2025
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