Andrew J. Madak, D.O., P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

510102535 Issued in MI

Legal business name

ANDREW J. MADAK, D.O., P.C.

Practice address

455 S Livernois Rd
C-22
Rochester Hills, MI 48307-2578

Phone

(248) 601-5780

Fax

(248) 605-8786

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Andrew John Madak, D.O.

Title

President

Phone

(248) 601-5780

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1891960092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S LIVERNOIS RD",
            "address_2": "C-22",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072578",
            "telephone_number": "248-601-5780",
            "fax_number": "248-605-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S LIVERNOIS RD",
            "address_2": "C-22",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072578",
            "telephone_number": "248-601-5780",
            "fax_number": "248-605-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J. MADAK, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "MADAK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-601-5780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "510102535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "56304394",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.