Individual
GLENN PANDALEON MCFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BCD 1ST FL, BOSTON, MA 02118-2908
(617) 414-5481
(617) 414-7759
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125.074171
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110186276A
—
MA
05
—
3137407
—
NH
Enumeration date
04/02/2019
Last updated
06/02/2023
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