Provider Demographics
NPI:1922016203
Name:ULLMAN, RONALD H (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:H
Last Name:ULLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1062
Mailing Address - Country:US
Mailing Address - Phone:509-663-9535
Mailing Address - Fax:509-667-8304
Practice Address - Street 1:2105 N. WESTERN AVE.
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-663-9535
Practice Address - Fax:509-667-8304
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-9096207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C64025Medicare UPIN