Organization
SAMUEL O FADARE, MD, PA
Active
Other names
SAMUEL O FADARE, MD, PC
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL O FADARE JR. MD (OWNER)
(816) 225-6735
Entity
Organization
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
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2006
Last updated
12/08/2020
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