DR. MARK AVERY FULLER (NPI# 1124055561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124055561 |
| Entity Type | Individual |
| Full Name | DR. MARK AVERY FULLER |
| Other Name | DR. MARK AVERY MOORE-FULLER |
| Credential | MD |
| Practice Address |
N10561 Grandview Lane Grandview Hospital Ironwood MI 49938-4828 |
| Mailing Address |
638 Lake Ave Ironwood MI 49938-1424 |
| Practice Telephone | 9069326211 |
| Mailing Telephone | 9063647105 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2009-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | 4301093004 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417470147 | Mark A Fuller | Taxi | 2215 W Willow Knolls Drive, Apt 503a, Peoria, IL 61614-1446 | 2017-07-25 |
| 1639270945 | Mark A Fuller | Chiropractor | 330 Curtis Ave, Ironton, MN 56455-0193 | 2006-09-26 |
| 1447751292 | Mark Joseph Fuller Jr. | Music Therapist | 1800 Columbus Ave, Boston, MA 02119-1042 | 2018-02-27 |
| 1780859744 | Mark P Fuller | Social Worker | W3275 Wolf River Road, Keshena, WI 54135 | 2008-04-29 |
| 1659378511 | Mark G Fuller | Internal Medicine | 1307 Federal St Ste 301, Pittsburgh, PA 15212-4769 | 2005-07-06 |
| Street Address |
N10561 GRANDVIEW LANE GRANDVIEW HOSPITAL |
| City | IRONWOOD |
| State | MI |
| Zip Code | 49938-4828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891319661 | Jonathon Rulseh | Physical Therapy Assistant | 10561 Grandview Ln, Ironwood, MI 49938 | 2020-06-08 |
| 1295107704 | Susanna Lee Harris | Counselor | 220 Roosevelt St, Ironwood, MI 49938 | 2015-10-22 |
| 1609214600 | Eve J. Komosa | Physician Assistant | N. 10561 Grand View Lane, Aspirus Grand View, Ironwood, MI 49938 | 2013-06-12 |
| 1255629861 | Tatyana G Bombard | Radiology | Aspirus Ironwood Hospital, N10561 Grand View Lane, Ironwood, MI 49938 | 2011-07-17 |
| 1205140761 | Allison Harr | Advanced Practice Midwife | N 10565 Grandview Lane, Ironwood, MI 49938 | 2010-07-27 |
| 1821267956 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 220 Rooselvelt Street, Ironwood, MI 49938 | 2008-02-22 |
| 1215106349 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 427 S. Stephenson Avenue, Suite 214, Iron Mountain, MI 49938 | 2008-02-22 |
| 1740466176 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 10305 Country Club Road, Ironwood, MI 49938 | 2008-01-16 |
| 1396811121 | Rebecca Lynn Mika | Occupational Therapist | 1310 E Cloverland Dr, Ironwood, MI 49938 | 2006-11-24 |
| 1306940432 | Marsha Miller Toohey | Chiropractor | 129 E Ayer St, Ironwood, MI 49938 | 2006-09-11 |
| Find all providers in zip 49938 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295343788 | Adult Patient Care Pllc | Hospitalist | 5496 Saint Andrew Dr, Clarkston, MI 48348-4836 | 2020-07-21 |
| 1790218360 | Eileen Chang | Hospitalist | 12745 S Saginaw St # 806-196, Grand Blanc, MI 48439-2437 | 2017-04-10 |
| 1588921357 | Erik Hemingway | Hospitalist | 1215 E. Michigan Ave., 7th Fl Tower, Lansing, MI 48912-1811 | 2012-04-18 |
| 1245533967 | Hussein Ajrouche, M.d., P.C. | Hospitalist | 12740 W Warren Ave Ste 200, Dearborn, MI 48126-4530 | 2010-12-20 |
| 1316178718 | Veni Jhansi Peram | Hospitalist | 20015 Boardwalk Blvd, Southfield, MI 48075-1158 | 2009-08-03 |
| 1932330511 | Aisha Zakia Rush | Hospitalist | 2 Hurley Plz Ste 212, Flint, MI 48503-5905 | 2009-07-31 |
| 1972773695 | Edward Peszko | Hospitalist | 307 East Houghton Ave, West Branch, MI 48661-1127 | 2008-03-10 |
| 1700069481 | Emmd Health Pllc | Hospitalist | 22319 Crestwood, Woodhaven, MI 48183 | 2007-12-17 |
| 1598874612 | Sripriya Ganesan | Hospitalist | 1675 Leahy St Ste 304b, Muskegon, MI 49442-5543 | 2006-08-30 |
| 1508971581 | Inpatient Medical Specialists, Plc | Hospitalist | 1675 Leahy St Ste 404b, Muskegon, MI 49442-5544 | 2006-08-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. MARK AVERY 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.