National Provider Identifier
Samuel Isaac Fuller, MD
Samuel Isaac Fuller, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 898-3000.
Profile Overview
- NPI
- 1851095939
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- March 30, 2023
- Last Updated
- March 30, 2023
Practice Location
- 462 Grider St
- Buffalo, NY 14215-3098
Phone: (716) 898-3000
Mailing Address
- 6416 Meadowbrook Dr
- Mentor, OH 44060-3668
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1851095939
- Entity Type
- Individual
- Last Name
- Fuller
- First Name
- Samuel
- Middle Name
- Isaac
- Credential
- MD
- Mailing Street Address
- 6416 Meadowbrook Dr
- Mailing City
- Mentor
- Mailing State
- OH
- Mailing ZIP Code
- 44060-3668
- Mailing Country
- US
- Mailing Phone
- (440) 223-3921
- Practice Street Address
- 462 Grider St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-3098
- Practice Country
- US
- Practice Phone
- (716) 898-3000
- Enumeration Date
- March 30, 2023
- Last Updated
- March 30, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 27, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)