person
Samantha Ellen Fullmer
General Practice Physician in Mesa, Arizona
NPI 1265031496

Samantha Ellen Fullmer is a General Practice Physician based in Phoenix, AZ. Samantha Ellen Fullmer practices in Mesa, AZ. The NPI Number for Samantha Ellen Fullmer is 1265031496 and holds a License No. 223113 (Arizona).

The current practice location address for Samantha Ellen Fullmer is 1705 W Main St, Mesa, AZ and can be reached out via phone at 480-964-2273 and via fax at 480-718-9477.

Location: 1705 W Main St, Mesa, AZ, 85012-2808
person
Provider Profile Details
NPI Number
1265031496
Provider Name
Samantha Ellen Fullmer
Credential
Provider Entity Type
Individual
Gender
Female
Address
1705 W Main St, Mesa, AZ, 85012-2808
Phone Number
480-964-2273
Fax Number
480-718-9477
Provider Enumeration Date
10/19/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1705 W Main St
City
State
Zip
85201-6920
Phone Number
480-964-2273
Fax Number
480-718-9477
person
Provider Business Mailing Address Details
Address
1705 W Main St
City
State
Zip
85201-6920
Phone Number
480-964-2273
Fax Number
480-718-9477
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
223113 (Arizona)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
223113 (Arizona)
Definition
Definition to come...
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