Most Relevant Information
Provider Data
| NPI Number: | 1003435132 |
| Provider Name: | CONNOR M FULTZ MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/09/2020 |
| Last Updated: | 06/15/2020 |
Provider Practice Location
1515 LOCUST STREET
FIRST FLOOR
PITTSBURGH
PA
152195114
Practice Location Phone/Fax
| Phone: | 4122328411 |
| Fax: |
Provider Mailing Location
3600 FORBES AVE STE 140
PITTSBURGH
PA
152133410
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |