Madison, Michael T

Madison, Michael T is an individual health care provider with primary practice located at 2355 Hwy 36 W. Ste. 100, Roseville MN 55113. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Madison, Michael T can be contacted via phone (651) 292-2000.

Contact Information

Primary practice address
2355 Hwy 36 W. Ste. 100 Roseville MN 55113
Phone: (651) 292-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 32412 Minnesota
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 32412 Minnesota

Profile Details

NPI number 1821077876
LBN Legal business name Madison, Michael T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jul 19th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821077876 NPPES
Minnesota MEDICAID 189307600

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