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General NPI Number Information
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NPI Number | 1356334544
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Entity Type | Organization
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Legal Business Name | ROBERT N. ULSETH, MD, PC
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 20 TREMONT ST BLDG 9, SUITE 17
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City | DUXBURY
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State | MA
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Zip | 02332-5310
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Country | US
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Telephone | 781-934-0135
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Fax | 781-934-0425
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Provider Business Mailing Address
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Address Line | PO BOX 2864
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City | DUXBURY
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State | MA
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Zip | 02331-2864
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Country | US
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Telephone | 781-934-0135
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Fax | 781-934-0425
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ROBERT NORMAN ULSETH
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Credential | MD
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Telephone | 781-934-0135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 49764
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License Number State | MA
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