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Provider Information for 1710978671

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DAVID FULTON MD

Gender: MALE

Individual NPI: 1710978671

Calendar   Last Updated:  2010-01-12
  Certification Date: 

Details

Name Value
NPI 1710978671
Enumeration Date 2005-10-31
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address PO BOX 9135 ATT: SHARON SILVA
BROOKLINE, MA 02446-9135
United States

Phone: 603-890-4404 | Fax:
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-2793 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID RI DF11109
MEDICAID MA 0111457
Other HEALTH NET MA 6162
Other NETWORK HEALTH MA 99134101
Other BCBS MA MA E05248
Other UNITED HEALTHCARE MA MA 7500359
Other HARVARD PILGRIM MA AA9214
Other NEIGHBORHOOD HEALTH PLAN MA 11530
Other CIGNA MA MA B20017601
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2080P0202X - Pediatrics Pediatric Cardiology MA 58948