Individual
ISAAC FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 320, COLUMBIA, SC 29203-6896
(803) 434-6771
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 434-6771
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6177
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/08/2024
Last updated
02/11/2026
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