Victor Maldonado, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301043142 Issued in MI

Practice address

36175 Harper Ave
Clinton Township, MI 48035-3274

Phone

(586) 741-3772

Fax

(586) 741-4604

NPI assigned

May 1, 2006

Last updated

Oct 25, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associated Radiologists of Oakland County PC

  • Diagnostic Radiology Physician
  • Pontiac, MI
  • NPI 1558468751
  NPD (past)
• Eastpointe Radiologists, P.C.

  dba Grosse Pointe Physicians Xray Center, PC

  • Diagnostic Radiology Physician
  • Detroit, MI
  • NPI 1881642056
  NPD (past)
• Eastpointe Radiologists, PC

  dba Grosse Pointe Physicians Xray Center, PC

  • Diagnostic Radiology Physician
  • Grosse Pointe Woods, MI
  • NPI 1558409649
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1144288275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36175 HARPER AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480353274",
            "telephone_number": "586-741-3772",
            "fax_number": "586-741-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36175 HARPER AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480353274",
            "telephone_number": "586-741-3772",
            "fax_number": "586-741-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "VICTOR",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MI",
            "license": "4301043142",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301043142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCCLAREN HEALTH",
            "identifier": "1006439",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4856349",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0Q26008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "Q26008059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0Q26008",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Marie Maier
• Nicolle Maikawa, M.D.
• Mohamad Makki, DO
• Martin J Makowski, DDS
• Josephine Makrush, LLPC
• Izabela Jadwiga Malewicz
• Michelle Mallino, SLP-CFY
• Mikayla Anne Mallory
• Maja Maloney, PA-C
• Katherine Maltester

• Diagnostic Radiology Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.