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Contact Information

BARRY R FULLER, MD
5477 W CLARK RD
YPSILANTI, MI48197-1102
 Phone: 734-434-6000
 Fax: 734-434-7005
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Ophthalmic Plastic and Reconstructive Surgery

207WX0200X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for BARRY R FULLER · (Male)

NPI Number 1134182645
Status Active
Credentials MD
Entity Individual
Enumeration date 04/07/2006
Last updated 07/07/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301075698
  • MI Medicaid 4195910
Hospital affiliation(s)
  • ST JOSEPH MERCY HOSPITAL - (Acute Care)
    5301 E HURON RIVER DR
    ANN ARBOR, MI 48106
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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