Individual
CHRISTOPHER J FULLAGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-4363
(315) 464-8690
Mailing address
750 E ADAMS ST, EMERGENCY MEDICINE, SYRACUSE, NY 13210-2306
(315) 464-4363
(315) 464-8690
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
228328
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02570487
—
NY
01
—
P00141078
RAILROAD MEDICARE
NY
Enumeration date
04/28/2006
Last updated
04/08/2011
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