Individual
BRUCE W. FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 W MOANA LN, RENO, NV 89509-4903
(775) 324-0699
(775) 323-6814
Mailing address
640 W MOANA LN, RENO, NV 89509-4903
(775) 324-0699
(775) 323-6814
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
19252
NV
207N00000X
Dermatology Physician
Primary
ME99153
FL
Other
Enumeration date
06/27/2007
Last updated
01/21/2026
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