Healthcare Provider Details

I. General information

NPI: 1598976987
Provider Name (Legal Business Name): JAMES WILLIAM FULCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MEMORIAL MEDICAL CT
GREENVILLE SC
29605-4449
US

IV. Provider business mailing address

8 MEMORIAL MEDICAL CT
GREENVILLE SC
29605-4449
US

V. Phone/Fax

Practice location:
  • Phone: 864-295-3492
  • Fax: 864-295-7127
Mailing address:
  • Phone: 864-295-3492
  • Fax: 864-295-7127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number31559
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number31559
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: