Provider Demographics
NPI:1730299165
Name:ULRICH A STARKE MD LLC
Entity Type:Organization
Organization Name:ULRICH A STARKE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ULRICH
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:STARKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-809-7171
Mailing Address - Street 1:PO BOX 848918
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8918
Mailing Address - Country:US
Mailing Address - Phone:985-893-6558
Mailing Address - Fax:985-893-4298
Practice Address - Street 1:102 HIGHLAND PARK PLZ
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7116
Practice Address - Country:US
Practice Address - Phone:985-893-6558
Practice Address - Fax:985-893-4298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5CV46Medicare PIN