Individual
PETER FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 SAINT ROSE PKWY, HENDERSON, NV 89052-3839
(702) 616-5000
Mailing address
1820 COUNTRY MEADOWS DR, HENDERSON, NV 89012-2236
(949) 350-2381
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17677
NV
Other
Enumeration date
05/15/2015
Last updated
12/27/2018
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