MEDICARE: NORA M FULLINGTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	249405	MA
2	208600000X	Surgery Physician	21217	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306073010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA M FULLINGTON M.D.

Provider Business Mailing Address
First Line	:	20 WALNUT ST STE 100
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2104
Country	:	US
Telephone Number	:	617-466-3373
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 WALNUT ST STE 100
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2104
Country	:	US
Telephone Number	:	617-466-3373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2009
Last Update Date	:	09/05/2025

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