Individual
HAROLD JONES FULLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2001-01044
NC
2084P0800X
Psychiatry Physician
Primary
38586
SC
2084P0805X
Geriatric Psychiatry Physician
200101044
NC
2084P0805X
Geriatric Psychiatry Physician
38586
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376578252
—
NC
05
—
891307G
—
NC
05
—
N0104H
—
SC
01
—
P01564416
RAILROAD MEDICARE
SC
Enumeration date
07/11/2006
Last updated
03/03/2023
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