Individual
BRITTANY S FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD # K14, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301100785
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301100785
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2012
Last updated
05/20/2020
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