Individual
DR. BRIAN J. FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2373 CENTRAL PARK BLVD, SUITE 303, DENVER, CO 80238-2300
(720) 220-7857
(303) 287-7357
Mailing address
3087 TEJON ST, SPT C, DENVER, CO 80211-3976
(720) 220-7857
(303) 320-2934
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
46857
CO
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
46857
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03433544
—
CO
Enumeration date
11/28/2006
Last updated
08/12/2011
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