Individual
DR. MARY SUSAN FULGHUM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3809 COMPUTER DR, SUITE 201, RALEIGH, NC 27609-6518
(919) 782-6700
(919) 782-2218
Mailing address
3809 COMPUTER DR, SUITE 201, RALEIGH, NC 27609-6518
(919) 782-6700
(919) 782-2218
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
17353
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012CT
BCBS
—
01
—
1220392
UHC
—
Enumeration date
04/12/2006
Last updated
07/08/2007
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