Individual
MEGAN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC SURGERY, PHILADELPHIA, PA 19104-4319
(217) 553-6708
(217) 553-6708
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC SURGERY, PHILADELPHIA, PA 19104-4319
(217) 553-6708
(217) 553-6708
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
29200
NE
2086S0120X
Pediatric Surgery Physician
MT205584
PA
Other
Enumeration date
05/31/2007
Last updated
07/21/2016
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