Durham, Madison D

Durham, Madison D is an individual health care provider with primary practice located at 38 Heritage Ct , Lockport NY 14094-3616. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Durham, Madison D can be contacted via phone (716) 986-9199.

Contact Information

Primary practice address
38 Heritage Ct Lockport NY 14094-3616
Phone: (716) 986-9199
Fax: (716) 304-1044
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X BG61193134 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA61187385 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 031185 New York

Profile Details

NPI number 1225707466
LBN Legal business name Durham, Madison D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 10th, 2021
Last updated Jan 29th, 2024 - about 2 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 1225707466 NPPES
Washington MEDICAID 2188015

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