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1922284504
CANDACE DONYUSHA CHARLES
O FALLON, IL
NPI
1922284504
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Former Name
CANDACE DONYUSHA MOSES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085004583)
Enumeration Date
2008-01-14
Last Update Date
2018-08-02
Business Address
-- CANDACE DONYUSHA CHARLES PA
4965 STONE FALLS CTR STE 7
O FALLON, IL 62269-7803
Phone number: 618-726-2500
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Mailing Address
-- CANDACE DONYUSHA CHARLES PA
3 PROFESSIONAL DR STE B
ALTON, IL 62002-5067
Phone number: 618-465-7177
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