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Individual

SHARI ANN FAHEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7373 FRANCE AVE S, SUITE 312, EDINA, MN 55435-4534
(952) 832-0076
(952) 832-9881
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9560
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112424
MEDICA
01
73B57FA
BLUE CROSS BLUE SHIELD
01
969991027685
PREFERREDONE
01
HP43531
HEALTHPARTNERS
Enumeration date
08/22/2006
Last updated
07/10/2007
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