Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DERRICK CORNELIUS FULLWOOD
Active Sole ProprietorMR. DERRICK CORNELIUS FULLWOOD is a Community/Behavioral Health healthcare provider located in CLINTON, North Carolina. NPI 1154656338 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · CLINTON, NC
Registration Details
- NPI Number
- 1154656338
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 6, 2009 (16.858723708263 yrs)
- Last Updated
- Oct 6, 2009
- Sole Proprietor
- Yes
Practice Information
- Address
-
4442 BONNETSVILLE RDCLINTON, NC, 283281001Browse NC providers · Browse ZIP 28328
- Phone
- 9196736332
- Primary Specialty
-
Community/Behavioral Health
251S00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.