EDWARD STEVEN FULLER

DETROIT, MI
NPI1932257672
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: MI  5601002984)
Enumeration Date2007-01-08
Last Update Date2007-07-08
Business Address
-- EDWARD STEVEN FULLER PA-C
22101 MOROSS ROAD
DETROIT, MI 48236-2172
Phone number: 313-343-6866
Mailing Address
-- EDWARD STEVEN FULLER PA-C
5041 YANKEE
ST. CLAIR, MI 48079
Phone number: 810-329-6435
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