Individual
DR. NICOLE PAIGE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(803) 341-1722
Mailing address
705 ROCK HILL CT, GREENVILLE, SC 29607-4883
(803) 341-1722
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
99993
GA
Other
Enumeration date
06/06/2022
Last updated
09/03/2024
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