Individual
DR. HARVEY LLOYD MADONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 ROUTE 72 W, MANAHAWKIN, NJ 08050-2412
(606) 978-8960
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MA73163
NJ
207R00000X
Internal Medicine Physician
Primary
0101242069
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871530733
—
VA
01
—
303316
BLUE SHIELD
VA
01
—
P00417572
RAILROAD MEDICARE
VA
Enumeration date
06/01/2006
Last updated
03/22/2021
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