Individual
ANNE CLARK MCFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1300 W LEHIGH AVE, PHILADELPHIA, PA 19132-2701
(215) 226-8800
(215) 226-8819
Mailing address
PO BOX 820933, PHILADELPHIA, PA 19182-0933
(215) 926-9010
(215) 226-8285
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA20067
CA
363AM0700X
Medical Physician Assistant
Primary
MA-055882
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
PA MEDICAID GROUP
PA
01
—
597586
TPI MEDICARE GROUP
PA
01
—
CD4829
TPI RAILROAD MEDICARE GROUP
PA
01
—
W5352
UPIN
CA
Enumeration date
01/29/2009
Last updated
03/07/2013
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