Individual
DR. BRANT R. FULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822
(570) 271-6328
(570) 271-6955
Mailing address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD072746L
PA
208800000X
Urology Physician
ME 104664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001857502
—
PA
Enumeration date
03/08/2006
Last updated
08/12/2020
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