IndividualActive
Michael Fullmer, DO
NPI 1780789099 · Pediatrics Physician · Payson, UT
Provider details
- NPI number
- 1780789099
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 7192373-1204 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
15 S 1000 E
Suite 200
Payson, UT 84651-5590
Phone: (801) 465-2800
Approximate (ZIP-level) locationGet directions
Mailing address
15 S 1000 E
Payson, UT 84651-5590
Registry dates
- Enumerated
- 2006-09-13
- Last updated
- 2011-03-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.