Fuller, Stanley Brian
Fuller, Stanley Brian is an individual health care provider with primary practice located at 2825 Lyndhurst Ave Ste 101, Winston Salem NC 27103-4146. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Fuller, Stanley Brian can be contacted via phone (336) 277-4075.Contact Information
Primary practice address
2825 Lyndhurst Ave Ste 101
Winston Salem NC 27103-4146
Phone: (336) 277-4075
Fax: (336) 277-4095
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 34605 | North Carolina |
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 34605 | North Carolina |
Profile Details
NPI number | 1437119302 |
---|---|
LBN Legal business name | Fuller, Stanley Brian |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 24th, 2006 |
Last updated | Jul 3rd, 2023 - about 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1437119302 | NPPES |
Virginia | MEDICAID | 1437119302 | |
Virginia | Other | 34605 | |
Virginia | MEDICAID | 8934129 |
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