Healthcare Provider Details
I. General information
NPI: 1710055009
Provider Name (Legal Business Name): JAMES MACFADYEN I M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/04/2006
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
979 SUNSET HOLLOW RD
WEST CHESTER PA
19380-1849
US
IV. Provider business mailing address
979 SUNSET HOLLOW RD
WEST CHESTER PA
19380-1849
US
V. Phone/Fax
- Phone: 610-436-0573
- Fax: 610-436-0573
- Phone: 610-436-0573
- Fax: 610-436-0573
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 013835E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 013835E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: