Individual
MR. DONALD MICHAEL FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
6419 CAROLINA BEACH RD, WILMINGTON, NC 28412-3671
(910) 332-3800
(910) 251-0421
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(919) 220-5255
(919) 220-6971
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P16610
NC
225100000X
Physical Therapist
Primary
PT014020L
PA
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018935630025
—
PA
01
—
001939987
BC/BS
—
01
—
P16610
STATE LICENSE
NC
Enumeration date
06/29/2006
Last updated
05/05/2026
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