Provider Demographics
NPI:1023200169
Name:MCFADDIN, GEORGE WESTON (MSPT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:WESTON
Last Name:MCFADDIN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 STOCKDALE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7125
Mailing Address - Country:US
Mailing Address - Phone:843-375-5448
Mailing Address - Fax:
Practice Address - Street 1:3301 STOCKDALE ST
Practice Address - Street 2:SUITE B
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7125
Practice Address - Country:US
Practice Address - Phone:843-375-5448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1206275225100000X
SC5552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist