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Contact Information

DOUGLAS R FULLEN, MD
1500 E MEDICAL CENTER DR
ANN ARBOR, MI48109-5000
 Phone: 734-936-4000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatopathology

207ZD0900X 22 Physician/Pathology
 

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for DOUGLAS R FULLEN · (Male)

NPI Number 1730260183
Status Active
Credentials MD
Entity Individual
Enumeration date 10/18/2006
Last updated 10/24/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301063830
  • MI Medicaid 4230027
Hospital affiliation(s)
  • CHELSEA COMMUNITY HOSPITAL - (Acute Care)
    775 S MAIN ST
    CHELSEA, MI 48118
  • ST JOSEPH MERCY HOSPITAL - (Acute Care)
    5301 E HURON RIVER DR
    ANN ARBOR, MI 48106
  • UNIVERSITY OF MICHIGAN HEALTH SYSTEM - (Acute Care)
    1500 E MEDICAL CENTER DRIVE, SPC 5474
    ANN ARBOR, MI 48109
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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