Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bruce W. Fuller, MD

Individual provider Dermatology Physician · NPI 1588861397

Bruce W. Fuller, MD is a Dermatology in Reno, Nevada. Graduated from Geisel School of Medicine at Dartmouth in 2003, 23 years ago. Practices with Mountain West Derm - Blackhart PLLC, a 103-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Nevada.

Years since qualifying
23
Trained at
Geisel School of Medicine at Dartmouth
Licensed in
NV
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

640 W Moana Ln
Reno, NV 89509-4903
Phone: (775) 324-0699
Fax: (775) 323-6814
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3950 Gs Richards Blvd, Carson City, NV 89703-8457 — (775) 882-8777

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 19252 (NV)

Record details

NPI number1588861397
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 27, 2007
Last updated in NPPESJanuary 21, 2026
Certification dateJanuary 21, 2026
Mailing address640 W Moana Ln, Reno, NV 89509-4903

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolGEISEL SCHOOL OF MEDICINE AT DARTMOUTH
Graduated 2003 (23 years in practice)
Group practice Mountain West Derm - Blackhart Pllc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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