Individual
SAM FAULKNER SHUMWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
7734 N 59TH AVE, GLENDALE, AZ 85301-7816
(602) 569-3999
(602) 569-3887
Mailing address
1533 E WILLETTA ST, PHOENIX, AZ 85006-2935
(602) 569-3999
(602) 569-3887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5284
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
863734
—
AZ
Enumeration date
02/08/2013
Last updated
08/23/2019
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