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1013374271
SHAWN FADUM
ARDMORE, OK
NPI
1013374271
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: OK 2640)
Enumeration Date
2016-01-19
Last Update Date
2022-07-21
Business Address
-- SHAWN FADUM PA
1104 WALNUT DR
ARDMORE, OK 73401-2353
Phone number: 580-226-0543
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Mailing Address
-- SHAWN FADUM PA
1104 WALNUT DR
ARDMORE, OK 73401-2353
Phone number: 580-226-0543
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