Individual
JORDAN DANIEL BROMAN-FULKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 VANDERBILT PARK DR, ASHEVILLE, NC 28803-1700
(828) 213-1740
Mailing address
29 SHERIDAN RD, ASHEVILLE, NC 28803-2228
(919) 641-6974
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210624
NC
390200000X
Student in an Organized Health Care Education/Training Program
210624
NC
Other
Enumeration date
05/11/2015
Last updated
09/08/2020
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