Individual
BRAD EDWARD FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 AFRICA RD STE 300, WESTERVILLE, OH 43082-9830
(614) 882-9460
(614) 882-9802
Mailing address
625 AFRICA RD STE 300, WESTERVILLE, OH 43082-9830
(614) 882-9460
(614) 882-9802
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.096344
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061071
—
OH
Enumeration date
03/25/2009
Last updated
10/31/2023
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