Healthcare Provider Details

I. General information

NPI: 1548073539
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL ULM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 ANDREWS AVENUE
FORT RUCKER AL
36362
US

IV. Provider business mailing address

301 ANDREWS AVENUE
FORT RUCKER AL
36362
US

V. Phone/Fax

Practice location:
  • Phone: 334-255-7040
  • Fax:
Mailing address:
  • Phone: 334-255-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number113993
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: