Individual
DR. BRIAN S ULLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8240
(314) 251-6816
Mailing address
625 S NEW BALLAS RD STE B011, SAINT LOUIS, MO 63141-8240
(314) 251-6816
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2001011439
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962420653
—
MO
05
—
208823906
—
MO
01
—
P01316033
RAILROAD MEDICARE
MO
Enumeration date
07/18/2006
Last updated
08/07/2023
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