Individual
GREGG S FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 PALMER AVE., BELLEFONTAINE, OH 43311-2281
(937) 592-4015
Mailing address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 593-0245
(937) 592-8633
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.081568
OH
208M00000X
Hospitalist Physician
Primary
35081568
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000026809
ANTHEM
—
05
—
2369057
—
OH
01
—
341407259
NATIONWIDE
—
01
—
341407259037
MEDICAL MUTUAL
—
01
—
7755544
AETNA
—
01
—
87726
UHC
—
01
—
FU7340041
TRICARE
—
Enumeration date
06/21/2006
Last updated
05/18/2022
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