Individual
DR. CONRAD CARNES FULKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 ACADEMY RD, STE 240, DURHAM, NC 27707-2660
(919) 493-3457
(919) 493-2290
Mailing address
742 ROBERT GENTRY RD, TIMBERLAKE, NC 27583-9018
(919) 493-3457
(919) 493-2290
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
19691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34107
BCBS OF NORTH CAROLINA
NC
Enumeration date
03/22/2007
Last updated
07/08/2007
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