Provider Demographics
NPI:1033282876
Name:MCFADDEN, THOMAS PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOODMAN WAY
Mailing Address - Street 2:UNIT 212A
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950
Mailing Address - Country:US
Mailing Address - Phone:978-463-0428
Mailing Address - Fax:
Practice Address - Street 1:50 WATER ST
Practice Address - Street 2:UNIT 148
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950
Practice Address - Country:US
Practice Address - Phone:978-462-2971
Practice Address - Fax:978-463-9526
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y35695OtherBLUE CROSS
AA7133OtherHARVARD PILGRIM
05Y004001MA01OtherANTHEM
MA1603973Medicaid
MCY45170Medicare ID - Type Unspecified
MA1603973Medicaid