Doctor Name: | DR. CARLOS ANGEL MEDINA-PADILLA |
NPI Number: | 1417990763 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14531 |
Business Practice Address: | 325 East H Street Oscar G. Johnson Va Medical Center Iron Mountain, MI - 498014792 |
Business Phone Number: | 9067743300 |
Business Fax Number: | 9067793124 |
Mailing Address: | 325 East H Street, Oscar G. Johnson Va Medical Center IRON MOUNTAIN |
State: | MI |
Postal Code: | 498014792 |
Phone Number: | 9067743300 |
Fax Number: | 9067793124 |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 07/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14531 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |