Individual
STEVEN D FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD DO
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 798-4314
(410) 798-4314
Mailing address
659 LOCH HAVEN RD, EDGEWATER, MD 21037-3101
(410) 798-4314
(410) 798-4314
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
H0036078
MD
Other
Enumeration date
06/10/2006
Last updated
07/23/2007
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