Individual
ROLLIN WILLIAM FULLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435
(952) 835-9880
(952) 857-1554
Mailing address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0099-00501
NC
207P00000X
Emergency Medicine Physician
33161
SC
207P00000X
Emergency Medicine Physician
48275
MN
207P00000X
Emergency Medicine Physician
Primary
65968
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255E
BCBSNC
NC
05
—
891255E
—
NC
01
—
930092980
RR MEDICARE
NC
Enumeration date
05/24/2006
Last updated
03/02/2026
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