Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SAM FULLER, MD
ActiveDR. SAM FULLER, MD is a Plastic and Reconstructive Surgery healthcare provider located in SOUTH BEND, Indiana. NPI 1649569484 is currently active in the NPPES registry. Verify at CMS.
Plastic and Reconstructive Surgery · SOUTH BEND, IN
Registration Details
- NPI Number
- 1649569484
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 1, 2011 (15.384164497534 yrs)
- Last Updated
- Sep 3, 2024
- Licenses
-
01075560A (IN)01075560A (IN)
Practice Information
- Address
-
53880 CARMICHAEL DRSOUTH BEND, IN, 466351567Browse IN providers · Browse ZIP 46635
- Phone
- 5742479441
- Fax
- 5742479442
- Primary Specialty
-
Plastic and Reconstructive Surgery
2086S0122X
- Additional Specialty
- Plastic and Reconstructive Surgery
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.