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General NPI Number Information
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NPI Number | 1871536482
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Entity Type | Individual
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Provider Name | STEVEN R. ULLRICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2624 DAWSON RD
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City | ALBANY
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State | GA
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Zip | 31707-1609
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Country | US
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Telephone | 229-888-1624
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E MOREHEAD ST STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28202-2742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 102272
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 49882
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License Number State | WI
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