Individual
MR. EDWIN S FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 MEDICAL CENTER DR, HARDEEVILLE, SC 29927-3446
(785) 770-5284
Mailing address
42 MERIDIAN RD, BEAUFORT, SC 29907-1404
(785) 770-5284
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R105765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000550734E
—
GA
05
—
00550734C
—
GA
Enumeration date
07/20/2006
Last updated
10/12/2025
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