Individual
MR. MICHEAL HAYDON SHRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6339
Mailing address
705 WILD HORSE CREEK DR, FAIRVIEW HEIGHTS, IL 62208-2047
(618) 954-3043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2022033888
MO
Other
Enumeration date
01/15/2021
Last updated
09/08/2022
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