Individual
TIMOTHY C MCFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 OAKLAND AVE, ELKHART, IN 46517-1533
(574) 533-1234
(574) 537-2652
Mailing address
2600 OAKLAND AVE, ELKHART, IN 46517-1533
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01040846A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000176956
ANTHEM
IN
05
—
200045940
—
IN
01
—
P00090622
RAILROAD MEDICARE PIN
IN
Enumeration date
06/06/2006
Last updated
05/08/2009
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