Individual
STEPHEN ROSS FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96 JONATHAN LUCAS STREET, SUITE 807 CSB, MSC623, CHARLESTON, SC 29425
(843) 792-2731
Mailing address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL86007
SC
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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