Healthcare Provider Details

I. General information

NPI: 1396723474
Provider Name (Legal Business Name): DENNIS E ULEWICZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 10/25/2020
Certification Date: 10/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 ROUTE 30 STE B
GREENSBURG PA
15601-9704
US

IV. Provider business mailing address

6321 ROUTE 30 STE B
GREENSBURG PA
15601-9704
US

V. Phone/Fax

Practice location:
  • Phone: 724-671-1740
  • Fax: 724-523-7724
Mailing address:
  • Phone: 724-671-1740
  • Fax: 724-523-7724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number35.125085
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.125085
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberMD065438L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD065438L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: