Individual
MICHAEL EDWIN FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
2425 SANSONNET LN, O FALLON, MO 63368-3597
(501) 658-6186
Mailing address
2425 SANSONNET LN, O FALLON, MO 63368-3597
(501) 658-6186
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/02/2015
Last updated
01/31/2023
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