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Individual

DR. DANIEL RICHARDS FULLMER

Active
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Individual

DR. DANIEL RICHARDS FULLMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-12249
ID
2085R0202X
Diagnostic Radiology Physician
Primary
MD00049079
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0285030
L&I-RADIA REST OF WA
WA
01
0377759
L&I-RADIA KING COUNTY
WA
01
0377766
L&I-SWEDISH RADIA EDMONDS
WA
05
1054630
WA
05
1114994738
ID
01
4019715
BCBS
01
4102721
BCBS
Enumeration date
03/02/2006
Last updated
03/10/2025
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