Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2120 | NC |
NPI | 1003079518 |
---|---|
Provider Name | Dr. Shemeeka L Mcfadden |
First Address | Vienna, VA 22182-3970 |
Second Address | Charlotte, NC 28217-4116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 05/12/2020 |