MEDICARE: DR. ARLAN F FULLER JR. 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
1	207VX0201X	Gynecologic Oncology Physician	35266	MA

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	:	1942207774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARLAN F FULLER JR. MD

Provider Business Mailing Address
First Line	:	620 WASHINGTON STREET
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890
Country	:	US
Telephone Number	:	781-756-7273
Fax Number	:	781-721-0725

Provider Business Practice Location Address
First Line	:	620 WASHINGTON STREET
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890
Country	:	US
Telephone Number	:	781-756-5000
Fax Number	:	781-279-3946

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	03/28/2017

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