Individual
MARK G FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1307 FEDERAL ST STE 301, PITTSBURGH, PA 15212-4769
(412) 359-3751
(412) 442-2335
Mailing address
1307 FEDERAL ST STE 301, PITTSBURGH, PA 15212-4769
(412) 359-3751
(412) 442-2335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD043300L
PA
2084P0800X
Psychiatry Physician
Primary
MD043300L
PA
2084P0802X
Addiction Psychiatry Physician
MD043300L
PA
Other
Enumeration date
07/06/2005
Last updated
09/30/2020
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