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Individual

DAVID B FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4190 CITY AVE, PHILADELPHIA, PA 19131-1626
(215) 871-6425
(215) 871-6490
Mailing address
4190 CITY AVE, PHILADELPHIA, PA 19131-1626
(215) 871-6425
(215) 871-6490

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
OS015425
PA
207Q00000X
Family Medicine Physician
DO-495
AL
207Q00000X
Family Medicine Physician
OS015425
PA

Other

Enumeration date
05/31/2006
Last updated
02/01/2016
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