Individual provider · Type 1 NPI

Michael Charles Gonzalez Fuller, MD

Student in an Organized Health Care Education/Training Program · Fargo, ND

NPI number 1407659683 Active

Practice location

5225 23rd Ave S
Fargo, ND 58104-7927

Call (406) 202-5134 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1407659683

Michael Charles Gonzalez Fuller, MD's National Provider Identifier is 1407659683, issued on Mar 31, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fargo, ND. The record was last updated on May 26, 2026.