Individual provider · Type 1 NPI
Tyler Torell Fullwood
Student in an Organized Health Care Education/Training Program · Gwynn Oak, MD
NPI number
1881491405
Active
Practice location
2116 Streamway Ct
Gwynn Oak, MD 21207-6093
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None 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.
About NPI 1881491405
Tyler Torell Fullwood's National Provider Identifier is 1881491405, issued on Mar 1, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Gwynn Oak, MD. The record was last updated on Mar 1, 2025.