Individual
MICHAEL ANDREW FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
510 N GREEN ST, VALENTINE, NE 69201-1932
(402) 376-2525
Mailing address
510 N GREEN ST, VALENTINE, NE 69201-1932
(402) 376-2525
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0102202188
VA
207X00000X
Orthopaedic Surgery Physician
47745
CO
207X00000X
Orthopaedic Surgery Physician
Primary
COPS404
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427228154
—
VA
Enumeration date
03/10/2008
Last updated
04/10/2026
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