DR. COLIN M FULLER M.D. NPI 1578555165

NPI Information

NPI: 1578555165
Provider Name: DR. COLIN M FULLER, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
2385 E PRATER WAY
SUITE 302
SPARKS, NV
ZIP 89434
Phone: (775) 356-4514
Get Directions

DR. Colin M Fuller, M.D. is a cardiovascular disease internal medicine in Sparks, NV. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. Colin M Fuller, M.D. NPI is 1578555165. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2385 E PRATER WAY
SUITE 302
SPARKS, NV
ZIP 89434-629
Phone: (775) 356-4514
Fax: (775) 356-4991

The NPI 1578555165 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/18/2005 and was last updated on 5/8/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	G26986	CALIFORNIA	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	3987	NEVADA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1578555165	OTHER		NPI
2	G26986	OTHER	CALIFORNIA	MEDICAL LICENSE
3	3987	OTHER	NEVADA	MEDICAL LICENSE
4	11040349	OTHER		CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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