Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLES BERRY FULLENWIDER, M.D.
ActiveDR. CHARLES BERRY FULLENWIDER, M.D. is a Neurological Surgery healthcare provider located in MUSKOGEE, Oklahoma. NPI 1447245063 is currently active in the NPPES registry. Verify at CMS.
Neurological Surgery · MUSKOGEE, OK
Registration Details
- NPI Number
- 1447245063
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 20, 2005 (20.919498387526 yrs)
- Last Updated
- May 1, 2023
- License
-
12300 (OK)
Practice Information
- Address
-
4318 W OKMULGEE STMUSKOGEE, OK, 744014648Browse OK providers · Browse ZIP 74401
- Phone
- 9186831238
- Fax
- 9186831239
- Primary Specialty
-
Neurological Surgery
207T00000X
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.