Provider Demographics
NPI:1881127728
Name:MCFADDEN, MICHAEL BATHOLOMEW (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BATHOLOMEW
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23600 COMMERCE PARK STE C
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5817
Mailing Address - Country:US
Mailing Address - Phone:216-329-4433
Mailing Address - Fax:866-502-2795
Practice Address - Street 1:23600 COMMERCE PARK STE C
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5817
Practice Address - Country:US
Practice Address - Phone:216-329-4433
Practice Address - Fax:866-502-2795
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1373252084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry