Provider Demographics
NPI:1306030499
Name:FULCHER, ERIC DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:FULCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 INDIAN RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2339
Mailing Address - Country:US
Mailing Address - Phone:419-754-3669
Mailing Address - Fax:
Practice Address - Street 1:3835 INDIAN RD
Practice Address - Street 2:
Practice Address - City:OTTAWA HILLS
Practice Address - State:OH
Practice Address - Zip Code:43606-2339
Practice Address - Country:US
Practice Address - Phone:419-754-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41464207P00000X
OH35.089940207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine