Individual provider · Type 1 NPI

Edward Steven Fuller, PA-C

Surgical Physician Assistant · Detroit, MI

NPI number 1932257672 Active

Practice location

22101 Moross Road
Detroit, MI 48236-2172

Call (313) 343-6866 Map

Mailing address

5041 Yankee
St. Clair, MI 48079

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X5601002984 (MI)

Surgical Physician Assistant: Definition to come...

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About NPI 1932257672

Edward Steven Fuller, PA-C's National Provider Identifier is 1932257672, issued on Jan 8, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.