Individual
JESSICA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7503 SURRATTS RD, MEDSTAR SOUTHERN MD HOSPITAL CENTER EMERGENCY DEPT, CLINTON, MD 20735-3358
(301) 868-8000
Mailing address
3205 OX MEADOW CT, OAK HILL, VA 20171-1747
(703) 626-2412
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005818
MD
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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