Individual
MR. DONALD JENKINS FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
401 N BROADWAY, RM 1360 WEINBERG BLDG., BALTIMORE, MD 21231-1146
(410) 955-8742
(410) 502-1746
Mailing address
1216A BALDWIN MILL RD, JARRETTSVILLE, MD 21084-1908
(410) 557-8389
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0000378
MD
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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