Healthcare Provider Details

I. General information

NPI: 1801850292
Provider Name (Legal Business Name): FRANCES SHAWN MADDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WEALTHY ST SE SUITE 290
GRAND RAPIDS MI
49506-2969
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC845
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-774-8345
  • Fax: 616-774-8350
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number4301077568
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: