Individual
DR. ERIC BRADLEY FULLER
Active
Individual
DR. ERIC BRADLEY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
125-058032
IL
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
036.132558
IL
207XP3100X
Pediatric Orthopaedic Surgery Physician
137416
CA
Other
Enumeration date
06/23/2010
Last updated
09/06/2016
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