Individual
MR. DONALD MICHAEL FULLER
Active
Individual
MR. DONALD MICHAEL FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T.
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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