Fuller, Wayne A

Fuller, Wayne A is an individual health care provider with primary practice located at 1700 Clinton St , Muskegon MI 49442-5502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Fuller, Wayne A can be contacted via phone (231) 726-3511.

Contact Information

Primary practice address
1700 Clinton St Muskegon MI 49442-5502
Phone: (231) 726-3511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X WF091854 Michigan

Profile Details

NPI number 1952390700
LBN Legal business name Fuller, Wayne A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Feb 28th, 2012 - about 12 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 1952390700 NPPES
Michigan MEDICAID 1578703252
Michigan Other MI1878017

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