Individual
DR. JASON MATTHEW FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6000
Mailing address
3405 CONDUCTOR CIR, GREER, SC 29651-4496
(214) 436-7094
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD91373
SC
Other
Enumeration date
03/31/2021
Last updated
07/27/2024
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