Individual
JOSEPH FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073
(248) 898-9060
(248) 898-9054
Mailing address
26901 BEAUMONT BLVD, SUITE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1861
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
271175
NY
207ZP0101X
Anatomic Pathology Physician
Primary
271175
NY
207ZP0101X
Anatomic Pathology Physician
54513 - 020
WI
Other
Enumeration date
11/01/2006
Last updated
01/17/2019
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