Individual
MICHAEL WADE FAASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
321 BULLFINCH RD, PANAMA CITY BEACH, FL 32407-7012
(850) 230-3275
(850) 230-3197
Mailing address
321 BULLFINCH RD, PANAMA CITY BEACH, FL 32407-7012
(850) 230-3275
(850) 230-3197
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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