Organization
DELAWARE SURGICAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND FULLER M.D. (OWNER)
(740) 363-1473
Entity
Organization
Contact information
Practice address
90 E WILLIAM ST, DELAWARE, OH 43015-2149
(740) 363-1473
(740) 369-5718
Mailing address
90 E WILLIAM ST, DELAWARE, OH 43015-2149
(740) 363-1473
(740) 369-5718
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35061615
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165182
—
OH
Enumeration date
10/10/2006
Last updated
08/22/2020
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