Individual
DAVID LEE ULRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 437 A, SAINT LOUIS, MO 63141-8232
(314) 251-3880
Mailing address
621 S NEW BALLAS RD, SUITE 437 A, SAINT LOUIS, MO 63141-8232
(314) 251-3880
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2536871
NY
207RG0100X
Gastroenterology Physician
01066972A
IN
207RG0100X
Gastroenterology Physician
Primary
2011004665
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200952330
—
IN
01
—
P00793169
RAILROAD MEDICARE
IN
01
—
P00844242
RAILROAD MEDICARE
IN
Enumeration date
06/17/2009
Last updated
02/23/2011
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