Individual
TIMOTHY C MCFADDEN
Active
Individual
TIMOTHY C MCFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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