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Individual
JOSEPH EDWARD FULLER JR.
Active
Individual
JOSEPH EDWARD FULLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6728
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001237197
—
CT
01
—
010023719CT01
ANTHEM BLUE SHIELD
CT
01
—
050298
CONNECTICARE
CT
01
—
080121275
RAILROAD MEDICARE
CT
01
—
0R0176
HEALTHNET
CT
01
—
2143993
CONNECTICARE
CT
01
—
P2877320
OXFORD HEALTH PLANS
CT
Enumeration date
07/31/2006
Last updated
02/02/2011
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