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Individual

WILLIAM C FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4400 W 69TH ST, STE 1500, SIOUX FALLS, SD 57108-8170
(605) 322-5700
(605) 322-5704
Mailing address
2400 S. MINNESOTA AVE, STE 100, SIOUX FALLS, SD 57105-3762
(605) 322-7510
(605) 322-6475

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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