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Individual

DR. SAMUEL O FADARE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5604 NE ANTIOCH RD, GLADSTONE, MO 64119-2327
(660) 372-1313
(660) 372-1339
Mailing address
1513 UNION AVE STE 2500, MOBERLY, MO 65270-9412
(660) 372-1313
(660) 372-1339

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
04-24672
KS
2084P0800X
Psychiatry Physician
Primary
103939
MO
2084P0800X
Psychiatry Physician
4301063006
MI
2084P0800X
Psychiatry Physician
90387
GA
2084P0800X
Psychiatry Physician
ME157175
FL

Other

Enumeration date
03/31/2006
Last updated
10/06/2022
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