Individual
DR. DANIEL H FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 NAVARRE PL STE 6600, SOUTH BEND, IN 46601-1173
(574) 647-8800
(574) 647-8896
Mailing address
3245 HEALTH DR., SUITE 100, GRANGER, IN 46530-3245
(547) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01068116A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200983330
—
IN
Enumeration date
05/27/2008
Last updated
07/19/2024
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