Individual
SHAWN LEE FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., J.D., M.P.H.
Contact information
Practice address
2901 TRANSPORT ST SE, ALBUQUERQUE, NM 87106-4382
(202) 680-0613
Mailing address
2720 KATHRYN AVE SE, ALBUQUERQUE, NM 87106-3104
(202) 680-0613
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD071809L
PA
Other
Enumeration date
09/12/2006
Last updated
08/18/2025
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