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Contact Information

SRINIVASA R MADHAVAN, MD
801 BROADWAY N
FARGO, ND58102-3641
 Phone: 701-234-5933
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for SRINIVASA R MADHAVAN · (Male)

NPI # 1043566607
Status Active
Credentials MD
Entity Individual
Enumeration date 07/31/2012
Last updated 06/20/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • ND License # 13694
Hospital affiliation(s)
  • CENTENNIAL MEDICAL CENTER - (Acute Care)
    12505 LEBANON ROAD
    FRISCO, TX 75035
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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