Individual
SHARON D FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2611 LAMAR CT, MARION, SC 29571-8487
(843) 453-6525
Mailing address
2611 LAMAR CT, MARION, SC 29571-8487
(843) 453-6525
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-1588651
TAX ID
SC
Enumeration date
08/22/2018
Last updated
08/22/2018
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