Individual
DAVID SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-9602
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-9602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2000175328
MO
Other
Enumeration date
01/14/2007
Last updated
03/22/2023
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