Individual
DR. GREGORY K FULCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1526 LAKE MURRAY BLVD, COLUMBIA, SC 29212-8622
(803) 749-1155
(803) 749-1786
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 749-1155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16062
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160621
—
SC
01
—
P00200656
RAILROAD MEDICARE
SC
Enumeration date
02/15/2007
Last updated
08/12/2022
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