Individual
BRIAN EDWARD FULLER
Active
Individual
BRIAN EDWARD FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
MD51960
TN
2084P0800X
Psychiatry Physician
Primary
MD51960
TN
Other
Enumeration date
04/19/2011
Last updated
05/22/2020
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