Individual
DR. JOSE M FULCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 JEFFERSON RD, NORTHFIELD, MN 55057-3081
(507) 663-9000
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30002
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602390800
—
MN
Enumeration date
05/17/2006
Last updated
03/10/2021
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