| James W Fuller Phd Inc | |
|
5412 Glenside Dr Ste B Richmond VA 23228-3995 | |
| (804) 967-0486 | |
| (804) 346-0066 |
| Full Name | James W Fuller Phd Inc |
|---|---|
| Speciality | Social Worker |
| Location | 5412 Glenside Dr Ste B, Richmond, Virginia |
| Authorized Official Name and Position | James Woodrow Fuller (CEP) |
| Authorized Official Contact | 8049670486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James W Fuller Phd Inc 2410 Larkwood Road Richmond VA 23294-4105 Ph: (804) 967-0486 | James W Fuller Phd Inc 5412 Glenside Dr Ste B Richmond VA 23228-3995 Ph: (804) 967-0486 |
| NPI Number | 1518054733 |
|---|---|
| Provider Enumeration Date | 10/08/2006 |
| Last Update Date | 05/07/2008 |
| Medicare PECOS PAC ID | 2769656966 |
|---|---|
| Medicare Enrollment ID | O20111128000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518054733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904000574 (Virginia) | Primary |
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