Individual
BRYAN ULRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(773) 495-3611
Mailing address
82 COMMONWEALTH AVE APT 11, BOSTON, MA 02116-3020
(773) 495-3611
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
289116
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
289116
STATE LICENSE NUMBER
MA
Enumeration date
08/16/2018
Last updated
07/31/2021
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