Organization
FAIRLAWN DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE W FULLER D.O. (PHYSICIAN)
(330) 864-9000
Entity
Organization
Contact information
Practice address
55 MERZ BLVD, SUITE A, FAIRLAWN, OH 44333-2895
(330) 864-9000
(330) 864-9004
Mailing address
55 MERZ BLVD, SUITE A, FAIRLAWN, OH 44333-2895
(330) 864-9000
(330) 864-9004
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
8780
OH
Other
Enumeration date
07/12/2006
Last updated
02/18/2013
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