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Individual

DR. DANIEL G FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
26250 EUCLID AVE, SUITE 611, EUCLID, OH 44132-3305
(216) 261-2606
(216) 261-9814
Mailing address
26250 EUCLID AVE STE 611, EUCLID, OH 44132-3693
(216) 261-2606
(216) 261-9814

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35041455F
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000127387
ANTHEM
OH
05
0360247
OH
01
1764868001
CIGNA
OH
01
341106740031
CARESOURCE
OH
01
4044677
AETNA
OH
01
50453
QUAL CHOICE
OH
01
56958
UNITED HEALTHCARE
OH
01
OC02324
NATIONWIDE HEALTH PLANS
OH
01
R41455
SUMMA CARE
OH
Enumeration date
06/30/2005
Last updated
03/18/2009
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