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Individual

SAMUEL KIRK SHEWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2000 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5550
(015) 874-6878
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9806476-1206
UT

Other

Enumeration date
10/01/2014
Last updated
03/29/2022
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