Provider Demographics
NPI:1972861854
Name:MCFADDEN, WILLIAM FREDERICK (M D)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FREDERICK
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 CHINABERRY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-3664
Mailing Address - Country:US
Mailing Address - Phone:803-790-2822
Mailing Address - Fax:803-551-2249
Practice Address - Street 1:3121 CHINABERRY DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-3664
Practice Address - Country:US
Practice Address - Phone:803-790-2822
Practice Address - Fax:803-551-2249
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMMD13757 MD208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice