Individual
MICHAEL CHAFIC FADDOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8 TOWN CENTER DR, BOWLING GREEN, MO 63334-2803
(573) 324-2241
(573) 324-9854
Mailing address
PO BOX 1239, HANNIBAL, MO 63401-1239
(573) 248-5403
(573) 248-5419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
2023048261
MO
Other
Enumeration date
06/06/2016
Last updated
07/29/2024
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