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NPI Code Detail

MEDICARE: DR. CHRISTINE E FULLER MD

MEDICARE:  DR. CHRISTINE E FULLER  MD
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
1207ZP0101XAnatomic Pathology Physician36654TN
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician35.127255OH

Other Identifiers

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

General Provider Information

NPI Number : 1851394019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE E FULLER MD
Provider Business Mailing Address
First Line : 3333 BURNET AVE
Second Line : ML 1035
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-4261
Fax Number : 513-636-3924
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line : ML 1035
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-4261
Fax Number : 513-636-3924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 10/08/2015

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