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Individual

ALLAN FAUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8405
Mailing address
3035 S 26TH ST, KALAMAZOO, MI 49048-9610
(269) 383-4285

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002043
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
757-4431
MI
Enumeration date
08/22/2006
Last updated
07/08/2007
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