Individual
BARBARA L FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 S LAKE PARK AVE, SUITE1101, HOBART, IN 46342-6641
(219) 947-1795
Mailing address
1600 S LAKE PARK AVE, SUITE 1101, HOBART, IN 46342-6641
(219) 947-1795
(219) 947-9834
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01034701A
IN
207RH0003X
Hematology & Oncology Physician
036056161
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056161
—
IL
05
—
100213850F
—
IN
05
—
100394430
—
IN
Enumeration date
06/12/2006
Last updated
01/02/2015
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