Individual
SCOTT R FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1000
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34.008827
OH
207P00000X
Emergency Medicine Physician
34008827
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2681156
—
OH
Enumeration date
06/26/2006
Last updated
11/07/2024
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