Individual
PETER F ULLRICH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5320 MICHAELS DR, APPLETON, WI 54913-8446
(920) 882-8200
(920) 882-8210
Mailing address
5320 MICHAELS DR, APPLETON, WI 54913-8446
(920) 882-8200
(920) 882-8210
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36628
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32123400
—
WI
Enumeration date
08/16/2005
Last updated
02/25/2013
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