Provider Demographics
NPI:1174798193
Name:BANGALORE, MADAN S (MD)
Entity type:Individual
Prefix:
First Name:MADAN
Middle Name:S
Last Name:BANGALORE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15825 SHADY GROVE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4008
Mailing Address - Country:US
Mailing Address - Phone:301-869-9776
Mailing Address - Fax:301-216-2592
Practice Address - Street 1:20410 OBSERVATION DR 210
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6422
Practice Address - Country:US
Practice Address - Phone:301-869-9776
Practice Address - Fax:301-417-4947
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2015-10-22
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Provider Licenses
StateLicense IDTaxonomies
MDD0067512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine