Individual provider Active NPI

Robert V Fulk Jr., M.D.

  • Otolaryngology Physician
  • Wilmington, NC
National Provider Identifier
1972830545
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
3291 Issued in NC
Practice address
764 Forest Hills Dr
Wilmington, NC 28403-2510
Phone
(910) 762-2518
NPI assigned
Nov 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 3291 NC Primary

Addresses

Primary practice location

764 Forest Hills Dr
Wilmington, NC 28403-2510

Mailing address

764 Forest Hills Dr
Wilmington, NC 28403-2510
Phone (910) 762-2518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14658NCMDPharmacist
3291NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steven and Michael Hochman Medical Corporation Inc. Past Accepting new patients
Wilmington Ear Nose & Throat Assoc., P.a. Otolaryngology PastSince Jun 2, 1997 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1972830545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 FOREST HILLS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032510",
            "telephone_number": "910-762-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 FOREST HILLS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032510",
            "telephone_number": "910-762-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULK",
        "first_name": "ROBERT",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-03",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "3291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.