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Organization
WEST SHORE WOMENS PRACTICE PC
Active
Organization
WEST SHORE WOMENS PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIAN R FULLER M.D. (CEO)
(231) 398-0222
Entity
Organization
Contact information
Practice address
1293 E PARKDALE AVE, SUITE 1200A, MANISTEE, MI 49660-8904
(231) 398-0222
(231) 398-0225
Mailing address
1293 E PARKDALE AVE, SUITE 1200A, MANISTEE, MI 49660-8904
(231) 398-0222
(231) 398-0225
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301079496
MI
Other
Enumeration date
12/31/2007
Last updated
09/11/2008
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