IndividualActive
Edward Fuller, PA-C
NPI 1932257672 · Surgical Physician Assistant · Detroit, MI
Provider details
- NPI number
- 1932257672
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5601002984 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
22101 Moross Road
Detroit, MI 48236-2172
Phone: (313) 343-6866
Approximate (ZIP-level) locationGet directions
Mailing address
5041 Yankee
St. Clair, MI 48079
Registry dates
- Enumerated
- 2007-01-08
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.