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Provider Information for 1538149687

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. JOSEPH RUSSELL MADSEN M.D.

Gender: MALE

Individual NPI: 1538149687

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1538149687
Enumeration Date 2006-01-17
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 11 BROKEN TREE RD
NEWTON, MA 02459-3415
United States

Phone: | Fax:
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Primary Practice Address 300 LONGWOOD AVE CHILDREN'S HOSPITAL BOSTON
BOSTON, MA 02115-5724
United States

Phone: 617-355-6005 | Fax: 617-730-0906
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Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 3041034
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207T00000X - Neurological Surgery MA 56378