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Individual
ROGER L FULTON
Active
Individual
ROGER L FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36065210
IL
208M00000X
Hospitalist Physician
036065210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006015346
BLUE CROSS BLUE SHIELD OF
IL
01
—
020011762
RAILROAD MEDICARE
—
05
—
036065210
—
IL
01
—
0403712
UNITED HEALTH CARE UHC
—
01
—
116583
HEALTH LINK
—
01
—
35030
CMR A DIVISION OF GHP
—
01
—
52553
GROUP HEALTH PLAN GHP
—
01
—
5828298
AETNA
—
Enumeration date
06/06/2006
Last updated
11/06/2014
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