Provider Demographics
NPI:1740489350
Name:FADELL, MICHAEL FREDERICK II (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FREDERICK
Last Name:FADELL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:725 WELCH RD RM 1890
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1601
Mailing Address - Country:US
Mailing Address - Phone:650-725-2548
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN ROAD DEPARTMENT OF RADIOLOGY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-1601
Practice Address - Country:US
Practice Address - Phone:919-684-7293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1667082085P0229X, 2085R0202X
AZ562422085P0229X
OH35.0860972085R0202X
NC3122962085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology