Individual
DR. BRIAN MATTHEW FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DEPT ANESTHESIOLOGY, SAINT LOUIS, MO 63110-1003
(800) 862-9980
(314) 362-1185
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(800) 862-9980
(314) 362-1185
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
2009013297
MO
207P00000X
Emergency Medicine Physician
2009013297
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205517303
—
MO
Enumeration date
05/25/2007
Last updated
04/17/2025
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