DR. BRUCE EVANS FULLER (NPI# 1538117890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538117890 |
| Entity Type | Individual |
| Full Name | DR. BRUCE EVANS FULLER |
| Credential | M.D. |
| Practice Address |
12695 Mcmanus Blvd Suite 3b Newport News VA 23602-4435 |
| Mailing Address |
Po Box 2579 Newport News VA 23609-0579 |
| Practice Telephone | 7578727787 |
| Practice Fax Number | 7578727727 |
| Mailing Telephone | 7578727787 |
| Mailing Fax Number | 7578727727 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 0101045701 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588861397 | Bruce W. Fuller | Dermatology | 1609 Pasadena Ave S Ste 4c, South Pasadena, FL 33707-4564 | 2007-06-27 |
| Street Address |
12695 MCMANUS BLVD SUITE 3B |
| City | NEWPORT NEWS |
| State | VA |
| Zip Code | 23602-4435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255329868 | Aaron Glenn Gould | Podiatrist | 12695 Mcmanus Blvd, Suite 1-d, Newport News, VA 23602-4435 | 2005-10-07 |
| 1477033561 | Jill Parramore | Counselor | 12695 Mcmanus Blvd, Newport News, VA 23602-4435 | 2018-08-17 |
| 1760732689 | American Addiction Treatment Center | Behavioral Analyst | 12695 Mcmanus Blvd, Suite 2, Newport News, VA 23602-4435 | 2012-09-18 |
| 1386808376 | Bruce E. Fuller, M.d, Pllc | Specialist | 12695 Mcmanus Blvd, Bldg 3, Suite B, Newport News, VA 23602-4435 | 2008-07-18 |
| 1619130200 | Kimberly Smith Phillips | Family Medicine | 12695 Mcmanus Blvd, Bldg 6, Suite A, Newport News, VA 23602-4435 | 2008-07-03 |
| 1184881922 | Walton Louis Bolger | Dentist | 12695 Mcmanus Blvd, Bldg 4 Suite A, Newport News, VA 23602 | 2008-05-20 |
| 1194932566 | A To Z Family Footcare | Podiatrist | 12695 Mcmanus Blvd, Suite 1d, Newport News, VA 23602 | 2007-05-16 |
| 1396870168 | Sheryl G Roemer | Dental Hygienist | 12695 Mcmanus Blvd, Suite 3a, Newport News, VA 23602 | 2007-02-22 |
| 1659412393 | Marie May Christopherson | Physical Therapist | 12695 Mcmanus Blvd, Bldg 6, Ste B, Newport News, VA 23602-4435 | 2007-02-08 |
| 1427106517 | Albert Franklin Creal Jr. | Dentist | 12695 Mcmanus Blvd, Building 3 Suite A, Newport News, VA 23602-4435 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789425 | Aishah Naomi Khursheed | Counselor | 727 J Clyde Blvd, Ste A, Newport News, VA 23602 | 2020-04-21 |
| 1962069526 | Boss Inner Child Counseling, LLC | Clinic/Center | 14203 Old Courthouse Way, Suite B, Newport News, VA 23602 | 2019-05-20 |
| 1922598572 | Manoj Chawla | Internal Medicine | 1000 Old Denbigh Blvd # 1020a, Newport News, VA 23602 | 2018-05-18 |
| 1750896999 | Alexandra Paige Jones | Behavioral Analyst | 12727 Mcmanus Blvd., Newport News, VA 23602 | 2017-12-11 |
| 1457712556 | Mary Ellen Lynch | Registered Nurse | American Addiction Treatment Center, 12695 Mcmanus Blvd, Bdg 2, Newport News, VA 23602 | 2016-03-16 |
| 1790159481 | Megan Ashley Burkart Schmidt | Registered Nurse | 903 Kinsale Cres, Newport News, VA 23602 | 2015-11-18 |
| 1962870733 | Natalie Marie Bradshaw-smith | Nurse Practitioner | 401 Oyster Point Rd Ste A, Newport News, VA 23602 | 2015-09-09 |
| 1477953578 | Jonathan Edwards | Pathology | Bon Secours Mary Immaculate Hospital, Pathology Dept, 2 Bernardine Dr, Newport News, VA 23602 | 2014-08-26 |
| 1588063663 | Cathy G Cooke | Psychologist | 12695 Mcmanus Blvd. Bldg #8, Newport News, VA 23602 | 2014-08-14 |
| 1538576764 | John Michael Sullivan | Psychologist | One Old Oyster Point Road, Newport News, VA 23602 | 2014-07-21 |
| Find all providers in zip 23602 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306949581 | Susan Elizabeth Mackel | Dermatology | 895 Middle Ground Blvd., Suite 302, Newport News, VA 23606-4250 | 2006-09-06 |
| 1427027978 | Valerie Magloire Harvey | Dermatology | 860 Omni Blvd Ste 112, Newport News, VA 23606-4430 | 2006-03-16 |
| 1457705733 | Anna Irene Clark | Dermatology | 500 J Clyde Morris Blvd Fl 2, Newport News, VA 23601-1929 | 2016-04-22 |
| 1558781807 | Brian Andrew Holloway | Dermatology | 12200 Warwick Blvd, Suite 490a, Newport News, VA 23601-2344 | 2014-04-24 |
| 1720285190 | Jason Daniel Mazzurco | Dermatology | 11844 Rock Landing Dr Ste B, Newport News, VA 23606 | 2007-06-29 |
| 1265535439 | Marnie Denise Titsch | Dermatology | 11844 Rock Landing Dr Ste B, Newport News, VA 23606 | 2006-09-06 |
| 1891807327 | Douglas Lloyd Nelson | Dermatology | 895 Middle Ground Blvd, Suite 302, Newport News, VA 23606-4250 | 2006-08-31 |
| 1366554883 | Pamela Beltran Cornelius | Dermatology | 895 Middle Ground Blvd, Suite 302, Newport News, VA 23606-4250 | 2006-08-31 |
| 1013028620 | Linda M. Serwatka | Dermatology | 11842 Rock Landing Dr, Suite 120, Newport News, VA 23606-4437 | 2006-08-31 |
| 1932168861 | Donald William Shenenberger | Dermatology | 11844 Rock Landing Dr, Suite B, Newport News, VA 23606 | 2006-03-20 |
| Find all providers in NEWPORT NEWS | ||||
| City | NEWPORT NEWS |
| Zip Code | 23602 |
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| 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.