Fullmer, Michael
Fullmer, Michael is an individual health care provider with primary practice located at 15 S 1000 E Suite 200, Payson UT 84651-5590. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fullmer, Michael can be contacted via phone (801) 465-2800.Contact Information
Primary practice address
15 S 1000 E Suite 200
Payson UT 84651-5590
Phone: (801) 465-2800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 7192373-1204 | Utah |
Profile Details
| NPI number | 1780789099 |
|---|---|
| LBN Legal business name | Fullmer, Michael |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Mar 8th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780789099 | NPPES |
| Utah | MEDICAID | 1497812721 |
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