Individual
DR. OLIVIA PENN MADAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1914 CHARLOTTE AVE STE 101, NASHVILLE, TN 37203-2231
(615) 327-0303
Mailing address
905 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4416
(864) 650-6228
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
60988
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659549608
PRACTICE NPI
TN
Enumeration date
06/06/2014
Last updated
02/16/2021
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