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Individual
DR. ITHIEL LOKEN AMES FULLER
Active
Individual
DR. ITHIEL LOKEN AMES FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0420011774
VT
207L00000X
Anesthesiology Physician
Primary
67242
CT
207L00000X
Anesthesiology Physician
84251
WI
Other
Enumeration date
04/25/2007
Last updated
01/06/2026
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