Individual
TERRENCE MALCOLM FULLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060
(202) 865-1286
Mailing address
2041 GEORGIA AVE NW TOWER 6101, WASHINGTON, DC 20060-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
D39720
MD
208600000X
Surgery Physician
Primary
MD15597
DC
Other
Enumeration date
08/21/2006
Last updated
12/06/2019
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