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Individual

JULIE MARIE FULTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8710 MANCHESTER RD, SAINT LOUIS, MO 63144-2724
(314) 961-3570
Mailing address
8710 MANCHESTER RD, SAINT LOUIS, MO 63144-2724
(314) 961-3570

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125.060358
IL
207R00000X
Internal Medicine Physician
Primary
2013021211
MO

Other

Enumeration date
07/01/2011
Last updated
01/03/2017
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