DR. RAYMOND EVERETT FULLER (NPI# 1073836250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073836250 |
| Entity Type | Individual |
| Full Name | DR. RAYMOND EVERETT FULLER |
| Credential | M.D. |
| Practice Address |
15 Andre St Se Grand Rapids MI 49507-3010 |
| Practice Telephone | 6164758446 |
| Practice Fax Number | 6164751272 |
| Mailing Telephone | 6164758446 |
| Mailing Fax Number | 6164751272 |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2010-03-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301023680 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639374408 | Raymond Lynnwood Fuller Jr. | Internal Medicine | 353 New Shackle Island Rd, Suite 245c, Hendersonville, TN 37075-2379 | 2007-06-20 |
| 1356424899 | Raymond D. Fuller | Surgery | 90 E William St, Delaware, OH 43015-2149 | 2006-10-20 |
| Street Address |
15 ANDRE ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49507-3010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992093298 | John Vander Kolk | Dentist | 15 Andre St Se, Grand Rapids, MI 49507-3010 | 2011-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487156956 | Kristen Zvirbulis Keeter | Physical Therapist | 625 Kenmoor Ave. Se Ste 306, Grand Rapids, MI 49507 | 2018-03-01 |
| 1508371758 | Vanessa Woodard | Case Manager/Care Coordinator | 1939 S. Division Ave., Grand Rapids, MI 49507 | 2017-12-11 |
| 1306350624 | Courtney Nicole Porter | Social Worker | 1979 S Division Ave., Grand Rapids, MI 49507 | 2017-11-22 |
| 1518496900 | 733 Prince LLC | Custodial Care Facility | 733 Prince St Se, Grand Rapids, MI 49507 | 2017-06-08 |
| 1720515406 | Tiffanie Ryder | Massage Therapist | 1110 Merrified St, Grand Rapids, MI 49507 | 2017-05-12 |
| 1619404308 | Shedrice's Afc | Respite Care | 246 Powell Se Ave, Grand Rapids, MI 49507 | 2017-05-12 |
| 1992171748 | Richard Lavell Flowers | Non-emergency Medical Transport (VAN) | 1447 Elliott, Grand Rapids, MI 49507 | 2015-08-17 |
| 1982096087 | Jordana Seebeck | Social Worker | 1939 S. Division Se, Grand Rapids, MI 49507 | 2015-02-26 |
| 1083973135 | Carla May Waite | Social Worker | 1939 South Division, Grand Rapids, MI 49507 | 2012-05-10 |
| 1740550037 | Jamie Lee Dalton | Social Worker | 2017 College Ave Se, Grand Rapids, MI 49507 | 2012-01-04 |
| Find all providers in zip 49507 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447299599 | Ronald Vanderlaan | Internal Medicine | 1310 E Beltline Ave Se, Ste 130, Grand Rapids, MI 49506-4303 | 2006-06-05 |
| 1942289798 | Michael G Dickinson | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525 | 2006-01-11 |
| 1952382137 | David Bryan Johnson | Internal Medicine | 638 Fulton St W, Suite B, Grand Rapids, MI 49504-6313 | 2005-11-07 |
| 1265423651 | Prerana Anand Manohar | Internal Medicine | 5043 Cascade Rd Se, Grand Rapids, MI 49546-3724 | 2005-11-03 |
| 1669984480 | Advanced Cardiac & Vascular Centers for Amputation Prevention Plc | Internal Medicine | 1525 E Beltline Ave Ne, Grand Rapids, MI 49525-4598 | 2017-11-02 |
| 1114389251 | Christopher Madison | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2016-03-28 |
| 1366804940 | Malav Parikh | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2016-03-23 |
| 1265849541 | Jose Mariano Tiu Tan II | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2014-07-17 |
| 1871919290 | Spectrum Health Primary Care Partners | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2014-03-10 |
| 1639591993 | Stefan Jovinge | Internal Medicine | 100 Michigan St Ne, Mc 231, Grand Rapids, MI 49503-2560 | 2014-01-06 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49507 |
Please comment or provide details below to improve the information on DR. RAYMOND EVERETT FULLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.