Individual
JULIE A FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2524 E WEBSTER PL, #301, MILWAUKEE, WI 53211-4256
(414) 272-7009
(414) 272-6261
Mailing address
2524 E WEBSTER PL, #301, MILWAUKEE, WI 53211-4256
(414) 272-7009
(414) 272-6261
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36737
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32198400
—
WI
Enumeration date
05/20/2006
Last updated
01/18/2011
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