Provider Demographics
NPI:1053486860
Name:ULMER, APRIL LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:LEE
Last Name:ULMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:APRIL
Other - Middle Name:L
Other - Last Name:ULMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:401 COWAN RD STE B
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-2022
Mailing Address - Country:US
Mailing Address - Phone:228-222-4072
Mailing Address - Fax:222-215-1205
Practice Address - Street 1:401 COWAN RD STE B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-2022
Practice Address - Country:US
Practice Address - Phone:228-222-4072
Practice Address - Fax:222-215-1205
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS197672080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06709263Medicaid
MS100001466Medicare PIN