# JOSEPH EDWARD FULLER JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376559351
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 6728 | NH | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 02/02/2011

## 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 |