Mark Allen Fullmer M.D.

NPI 1457420853 - Surgery - 208600000X

NPI Details
NPI 1457420853
Gender Male
Enumeration Date 11/07/2006
Last Updated 07/17/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
1055 N 300 W
SUITE 418
PROVO UT, 84604-3344, US
Phone (801) 357-7100
Fax (801) 357-8100
Business Location
1055 N 300 W
SUITE 418
PROVO UT, 84604-3344, US
Phone (801) 357-7100
Fax (801) 357-8100
Toxanomy
Taxonomy Code 208600000X
License State Utah
License Number 152450-1205
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According to our database, Dr. Mark Allen Fullmer M.D. NPI is 1457420853, taxonomy code is 208600000X and license number is 152450-1205, license state is located at Utah. Mark Allen Fullmer M.D. physically located at 1055 N 300 W, Provo UT, 84604-3344. NPI Number Mark Allen Fullmer M.D. has the Individual type.

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1457420853 NPI number is provided on an as is basis without warranty of any kind. 1457420853 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Allen Fullmer M.D. are for informational purposes only.