Individual
SEAN E FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214
Mailing address
PO BOX 2747, SHAWNEE MISSION, KS 66201-2747
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD159272
MO
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD159272
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100395150A
—
KS
05
—
205437502
—
MO
01
—
29256017
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/20/2005
Last updated
06/30/2021
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