Individual
ICHCHHA MADAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE # A121, BALTIMORE, MD 21224-2735
(410) 550-0336
(410) 550-0196
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301091439
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
D90730
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982862926
—
MI
Enumeration date
05/27/2008
Last updated
08/10/2021
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