Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 35061676 | OH |
NPI | 1104199884 |
---|---|
Provider Name | Dr. Roy M Kulick |
First Address | Cincinnati, OH 45215-2519 |
Second Address | Cincinnati, OH 45215-2519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2012 |
Last Update Date | 11/02/2012 |