Provider Demographics
NPI:1114967585
Name:FARMER, ULANA V (MD)
Entity Type:Individual
Prefix:
First Name:ULANA
Middle Name:V
Last Name:FARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 KINGSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3626
Mailing Address - Country:US
Mailing Address - Phone:401-789-0283
Mailing Address - Fax:401-789-0314
Practice Address - Street 1:481 KINGSTOWN RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3626
Practice Address - Country:US
Practice Address - Phone:401-789-0283
Practice Address - Fax:401-789-0314
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10548207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRI10548OtherBLUE CROSS LICENSE RI
RI409125OtherBLUE CHIP HMORI RI
RI7009420Medicaid
RI0102817OtherUNITEDHEALTHCARE
RIMD10548OtherSTATE LICENSE OF RI
RI409125OtherBLUE CHIP HMORI RI
RI7009420Medicaid