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Individual

NATHANIEL J FULLERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
611 E SHERMAN AVE, FORT ATKINSON, WI 53538-1960
(920) 568-5411
(920) 568-4004
Mailing address
PO BOX 249, FORT ATKINSON, WI 53538-0249
(920) 568-5411
(920) 568-4004

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38510-20
WI

Other

Enumeration date
02/22/2006
Last updated
04/11/2018
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