Individual
DR. MOLLY LYNN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
122 E KINDERTON WAY, BERMUDA RUN, NC 27006-7303
(336) 448-3060
(336) 998-3333
Mailing address
5335 ROBINHOOD VILLAGE DR # 178, WINSTON SALEM, NC 27106-9820
(336) 448-3060
(336) 998-3333
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2015-01115
NC
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
2015-01115
NC
Other
Enumeration date
06/26/2009
Last updated
04/05/2019
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