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Individual

PAUL T FADDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6525 FRANCE AVE S, SUITE 200, EDINA, MN 55435-2148
(952) 927-6501
(952) 653-1435
Mailing address
6525 FRANCE AVE S, SUITE 200, EDINA, MN 55435-2148
(952) 927-6501
(952) 653-1435

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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