CARLOS SAN PEDRO MADAMBA (NPI# 1811994866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811994866 |
| Entity Type | Individual |
| Full Name | CARLOS SAN PEDRO MADAMBA |
| Credential | MD |
| Practice Address |
51 N 39th St Philadelphia PA 19104-2640 |
| Practice Telephone | 8569066273 |
| Mailing Telephone | 8569066273 |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2016-09-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
25MA05508600 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 6042201 | 05 |
| Street Address |
51 N 39TH ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-2640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679570733 | Tanya M Dougherty | Pharmacist | 51 N 39th St, 6th Floor Mutch Building, Philadelphia, PA 19104-2640 | 2005-07-05 |
| 1114527058 | Laureen Delgado | Nurse Practitioner | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-10-29 |
| 1629677331 | Annabell Boreland | Nurse Practitioner | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-10-23 |
| 1174120190 | Kerry Jane Benson | Dietitian, Registered | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-10-02 |
| 1487251591 | Ashley Nichole Williams | Nurse Practitioner | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-10-02 |
| 1245844687 | Matthew Hinton | Pharmacist | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-09-02 |
| 1093323768 | Lindsey Morgan Duboff | Physician Assistant | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-07-20 |
| 1184240830 | Ashley Danielle Kelly | Nurse Anesthetist, Certified Registered | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-06-18 |
| 1992321863 | Cassie Deann Prendergast | Nurse Anesthetist, Certified Registered | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-06-17 |
| 1972126951 | Theresa Marie Carbone | Registered Nurse | 51 N 39th St, Philadelphia, PA 19104-2640 | 2020-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760947840 | Russell Eugene Kaufman | Internal Medicine | 700 Glengarry Rd, Philadelphia, PA 19118-4111 | 2019-02-04 |
| 1891204921 | Ahmed Mostafa | Internal Medicine | Hahnemann University Hospital, 230 N. Broad St., Philadelphia, PA 19102 | 2017-09-20 |
| 1780077735 | Arnon I Dreyfuss | Internal Medicine | 239 Delancey St, Philadelphia, PA 19106-4318 | 2015-03-16 |
| 1215240932 | Hayley Michelle Knollman | Internal Medicine | 3400 Civic Center Blvd Fl 10, Philadelphia, PA 19104-5158 | 2010-07-22 |
| 1134455207 | Justine V. Cohen | Internal Medicine | 230 W Washington Sq Fl 2, Philadelphia, PA 19106-3500 | 2009-10-26 |
| 1528393899 | Madiha Atif Gilani | Internal Medicine | 834 Chestnut St., Suit 320, Ben Franklin House, Philadelphia, PA 19107 | 2009-10-05 |
| 1609057660 | Temple Physicians Inc. | Internal Medicine | 7500 Central Ave Ste 110, Philadelphia, PA 19111-2430 | 2007-11-19 |
| 1366500613 | Curtis A Alloy Do PC | Internal Medicine | 2221 S Broad St, Philadelphia, PA 19148 | 2006-12-05 |
| 1326159021 | Rodwige J Desnoyers | Internal Medicine | 925 Chestunut Street, Suite 320a, Philadelphia, PA 19107 | 2006-08-31 |
| 1770514499 | Donna J Glover | Internal Medicine | Two Franklin Town Blvd, Suite #100, Philadelphia, PA 19103 | 2006-07-05 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on CARLOS SAN PEDRO MADAMBA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.