Individual
DR. FULLER MCIVER PRICKETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1330 TAYLOR ST, COLUMBIA, SC 29201-2915
(803) 296-5137
(803) 296-5499
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 434-6412
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19571
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195719
—
SC
Enumeration date
02/08/2006
Last updated
03/09/2021
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