Individual
SHAWN M FAUSSET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4000
(765) 502-4023
Mailing address
PO BOX 78838, DETROIT, MI 48278-0838
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02005037A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018947
—
IN
Enumeration date
04/07/2014
Last updated
10/20/2023
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