Provider Demographics
NPI:1801850292
Name:MADDEN, FRANCES SHAWN (MD)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:SHAWN
Last Name:MADDEN
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 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 WEALTHY ST SE
Practice Address - Street 2:SUITE 290
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2969
Practice Address - Country:US
Practice Address - Phone:616-774-8345
Practice Address - Fax:616-774-8350
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010775682081P2900X, 2081P2900X
OK272592081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7000024591OtherPRIORITY HEALTH MEDICAID
MI0D16000012Medicare ID - Type Unspecified
0411091OtherBLUE CROSS BLUE SHIELD
MI4532340Medicaid
7000024591OtherPRIORITY HEALTH
19187OtherHEALTH PLAN OF MICHIGAN
G26375Medicare UPIN
5796773OtherAETNA
OKG26375Medicare UPIN
MI4296646Medicaid
MI4296664Medicaid
0000146424005OtherUNITED HEALTH CARE
5067637OtherCIGNA
MI4767801Medicaid