Provider Demographics
NPI:1730256769
Name:MADATI, PONDA JAMIL (MD)
Entity type:Individual
Prefix:MR
First Name:PONDA
Middle Name:JAMIL
Last Name:MADATI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:DIVISION OF EMERGENCY MEDICINE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-4177
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:DIVISION OF EMERGENCY MEDICINE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2022-10-21
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Provider Licenses
StateLicense IDTaxonomies
DCMD0409822080P0204X
IL0361615272080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine