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Individual
JEFFERY MCFADDEN
Active
Individual
JEFFERY MCFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2901017434
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104818482
—
MI
05
—
124811848
—
MI
01
—
OH20333
BLUE CROSS MI
MI
Enumeration date
07/27/2006
Last updated
11/11/2008
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