Individual
STEPHEN C FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3916 N INTERTECH CT, APPLETON, WI 54913
(920) 996-1000
Mailing address
1813B N ONEIDA ST, APPLETON, WI 54911-2915
(920) 716-0574
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27889-020
WI
Other
Enumeration date
09/20/2005
Last updated
07/19/2024
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