Provider Demographics
NPI:1447301825
Name:MCFADDEN, JEVON DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JEVON
Middle Name:DAVID
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:201 TOWNSEND ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933-1551
Mailing Address - Country:US
Mailing Address - Phone:517-335-8900
Mailing Address - Fax:517-335-8263
Practice Address - Street 1:201 TOWNSEND ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-1551
Practice Address - Country:US
Practice Address - Phone:517-335-8900
Practice Address - Fax:517-335-8263
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI53160-020207R00000X
MI4301094728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine