Basic Information
| Provider Information | |||||||||
| NPI: | 1215111398 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCFADDEN | ||||||||
| FirstName: | PATRICIA ANN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 136 | ||||||||
| Address2: | |||||||||
| City: | LEWISTON | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042430136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032252711 | ||||||||
| FaxNumber: | 6032246527 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 PLEASANT ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033017559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032252711 | ||||||||
| FaxNumber: | 6032246527 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/24/2007 | ||||||||
| LastUpdateDate: | 06/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD446585 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | D0069164 | MD | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 046036 | CT | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD60456907 | WA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 17019 | NH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 042.0013162 | VT | N | Allopathic & Osteopathic Physicians | Family Medicine | 207L00000X | 17019 | NH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 3101988 | 05 | NH | MEDICAID |