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Madison Elizabeth Hanson

Internal Medicine

Allopathic & Osteopathic Physicians

3601 W 13 Mile Rd, Royal Oak, MI 48073-6712

PECOS Enrollment

This provider is enrolled in PECOS as MADISON HANSON.

Based on the most recent information from CMS, provider Madison Elizabeth Hanson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:21 AM.

Profile Details

Provider ID
1215666078
Provider Type
Individual
Full Name
Hanson, Madison Elizabeth
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
6/7/2022
Last Updated
6/7/2022

Contact Information

Practice Location

3601 W 13 Mile Rd, Royal Oak, MI 48073-6712

(248) 898-5000

Unlisted Fax

Mailing Location

3601 W 13 Mile Rd Ofc, Royal Oak, MI 48073-6712

(248) 551-6498

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 4351049605 Michigan
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License 4351049605 Michigan

Provider Identifiers

ID	Description	Issuer
ID 4351049605	Description Other	Issuer STATE MEDICAL LICENSE Michigan

Madison Elizabeth Hanson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Shelby-Lane, Cynthia A

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Norman J Kakos Md Pc

Khaskheli, Sarah Ashraf

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Hanna, Lilian

El Sayed, Farah

Moazzam, Mujtaba

Shrouf, Ahmad Jamal Ali

Sardarli, Kamil