Michael N Fulton, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

ME036059 Issued in FL

Practice address

3127 W International Speedway Blvd
Daytona Beach, FL 32124-1070

Phone

(386) 258-9502

Fax

(386) 239-9781

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1295701670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241070",
            "telephone_number": "386-258-9502",
            "fax_number": "386-239-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3127 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241070",
            "telephone_number": "386-258-9502",
            "fax_number": "386-239-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "MICHAEL",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME036059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Fuentes
• Richard Mitchel Fuentes, DPT
• Kathleen Fulks
• Barbara Fuller
• Christyn Fuller, APRN
• Kristi Fuson, APN
• Evan Fynes, M.D.
• Sagar Gada, MD
• Sheryl Beth Gage, LCSW
• Amy Catrina Gagne, RPH

• Sports Medicine (Orthopaedic Surgery) Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.