Individual
CHARLES O FULLENWIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-8937
Mailing address
333 S 38TH ST, SUITE F, MUSKOGEE, OK 74401-4937
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
31587
OK
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
31587
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2013
Last updated
05/27/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us