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Individual
PAUL T FADDEN
Active
Individual
PAUL T FADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
44963
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080822900
—
MN
01
—
19003930
MEDICA
—
01
—
34452FA
BS
—
Enumeration date
03/02/2007
Last updated
11/10/2015
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