Individual
CARLY ROSE ULRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1220 LEE ST E STE 100, CHARLESTON, WV 25301-1864
(304) 388-1965
Mailing address
3200 MACCORKLE AVE SE FL 4, CHARLESTON, WV 25304-1227
(304) 388-5590
(304) 388-8238
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
06149
KY
208800000X
Urology Physician
Primary
4878
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457811309
—
WV
Enumeration date
03/25/2019
Last updated
08/03/2026
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