Provider Demographics
NPI:1942297460
Name:UHLMAN, MARK SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:SCOTT
Last Name:UHLMAN
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 1:2500 RACQUET LN
Mailing Address - Street 2:STE 100
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-6114
Mailing Address - Country:US
Mailing Address - Phone:509-249-3900
Mailing Address - Fax:509-573-9539
Practice Address - Street 1:2500 RACQUET LN
Practice Address - Street 2:STE 100
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6114
Practice Address - Country:US
Practice Address - Phone:509-249-3900
Practice Address - Fax:509-573-9539
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYTL6528208800000X
WY13556A208800000X
WA025209MD00023482208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA340011805OtherRAILROAD MEDICARE PIN
WA1012590Medicaid
WA340010678OtherRAILROAD MEDICARE PIN
WAG115119103Medicare PIN
WA340011805OtherRAILROAD MEDICARE PIN
WAG115145901Medicare PIN