Individual
WILLIAM C FULLER
Active
Individual
WILLIAM C FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2080
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040695
BLUE CROSS
SD
01
—
114837
UCARE
MN
05
—
12200
—
ND
01
—
140M0FU
CC SYSTEMS/ BLUE PLUS
MN
01
—
14649
MIDLANDS CHOICE
SD
05
—
1958108
—
IA
01
—
2080
DAKOTACARE
SD
01
—
23086
SANFORD HEALTH PLAN
SD
01
—
25065
ARAZ/ AMERICA'S PPO
SD
01
—
260051611
RR MEDICARE
SD
05
—
394885400
—
MN
01
—
412991010162
PREFERRED ONE
SD
05
—
46022474352
—
NE
01
—
57108C008
WPS TRICARE
SD
05
—
7100103
—
SD
01
—
HP24848
HEALTHPARTNERS
SD
Enumeration date
02/07/2006
Last updated
12/11/2013
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