Individual
DR. BRUCE VISCHER MACFADYEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
DEPARTMENT OF SURGERY, BI 4076, MEDICAL COLL OF GEORGIA, 1102 15TH STREET, AUGUSTA, GA 30912
(706) 721-4651
(706) 721-2063
Mailing address
3122 MONTPELIER DR, AUGUSTA, GA 30909-3226
(706) 729-1700
(706) 721-2063
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
051251
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00942983A
—
GA
Enumeration date
08/22/2006
Last updated
07/08/2007
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