Bruce E. Fuller, M.D, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101045701 Issued in VA

Legal business name

BRUCE E. FULLER, M.D, PLLC

Practice address

12695 McManus Blvd
BLDG 3, Suite B
Newport News, VA 23602-4435

Phone

(757) 872-7787

Fax

(757) 872-7727

NPI assigned

Jul 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Evans Fuller, M.D.

Title

Dermatologist

Phone

(757) 872-7787

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1386808376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2579",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236090579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12695 MCMANUS BLVD",
            "address_2": "BLDG 3, SUITE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024435",
            "telephone_number": "757-872-7787",
            "fax_number": "757-872-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE E. FULLER, M.D, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "EVANS",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "757-872-7787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101045701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tramaine Leanne Brown
• Edythe Anne Browne, NURSE PRACTITIONER
• Cornelia Browning-Moore, LCSW
• Stephanie Browning, MS, ATC
• Daniel John Broza, O.D.
• Ashley M Brumskin
• Christine Abigail Brundage, LCSW
• Eleanor Bryant, LPC
• Emma Bryant
• Sterling Bryant

• Specialist in Newport News, VA
• Providers in Newport News, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.