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Contact Information

HAROLD J FULLER JR, MD
391 SERPENTINE DR
SUITE 400
SPARTANBURG, SC29303-3096
 Phone: 864-560-7517
 Fax: 864-560-7520
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for HAROLD J FULLER JR · (Male)

NPI # 1376578252
Status Active
Credentials MD
Entity Individual
Enumeration date 07/11/2006
Last updated 03/03/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 2001-01044
  • NC License # 200101044
  • SC License # 38586
  • NC Medicaid 1376578252
  • NC Medicaid 891307G
  • SC Medicaid N0104H
  • SC Other P01564416 RAILROAD MEDICARE
Hospital affiliation(s)
  • SPARTANBURG REGIONAL MEDICAL CENTER - (Acute Care)
    101 E WOOD ST
    SPARTANBURG, SC 29303
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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