Individual
ROSS FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2247
(404) 686-4411
Mailing address
2236 DESMOND DR, DECATUR, GA 30033-4742
(404) 702-8434
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
GA
Other
Enumeration date
07/31/2007
Last updated
08/09/2007
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