Provider Demographics
NPI:1801061718
Name:JAMES M. ULERY JR MD PC
Entity type:Organization
Organization Name:JAMES M. ULERY JR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:ULERY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:734-457-4400
Mailing Address - Street 1:PO BOX 742
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-0742
Mailing Address - Country:US
Mailing Address - Phone:734-457-4400
Mailing Address - Fax:734-242-8017
Practice Address - Street 1:1310 N MACOMB ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3131
Practice Address - Country:US
Practice Address - Phone:734-457-4400
Practice Address - Fax:734-242-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJU063597207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI070581056OtherBCBSM
MI070581056OtherBCBSM
MIG39845Medicare UPIN
MI0M85980Medicare PIN