Fuller, Karl R

Fuller, Karl R is an individual health care provider with primary practice located at 1275 Elm St , West Springfield MA 01089-1820. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fuller, Karl R can be contacted via phone (413) 785-1153.

Contact Information

Primary practice address
1275 Elm St West Springfield MA 01089-1820
Phone: (413) 785-1153
Fax: (413) 781-4951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1110 Massachusetts

Profile Details

NPI number 1043255821
LBN Legal business name Fuller, Karl R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043255821 NPPES
Massachusetts Other M15170 BCBS

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