Provider Demographics
NPI:1588036750
Name:MCCADDEN, TAI (MD)
Entity Type:Individual
Prefix:
First Name:TAI
Middle Name:
Last Name:MCCADDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ALABAMA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4540
Mailing Address - Country:US
Mailing Address - Phone:202-834-5056
Mailing Address - Fax:
Practice Address - Street 1:1100 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4540
Practice Address - Country:US
Practice Address - Phone:202-834-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1290882084P0800X
GA0748762084P0800X
DCMD0443212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry