Provider Demographics
NPI:1316576812
Name:TOSANOVIC, MADELEINE CHANDLER (MD)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:CHANDLER
Last Name:TOSANOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:CHANDLER
Other - Last Name:EICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 S ARLINGTON ST UNIT 38
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3771
Mailing Address - Country:US
Mailing Address - Phone:888-975-9188
Mailing Address - Fax:330-564-9977
Practice Address - Street 1:1400 S ARLINGTON ST UNIT 38
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3771
Practice Address - Country:US
Practice Address - Phone:888-975-9188
Practice Address - Fax:330-564-9977
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.150865207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program