Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | L6204 | TX |
NPI | 1063441772 |
---|---|
Provider Name | Dr. Scott C Ulmer |
First Address | San Antonio, TX 78258-3987 |
Second Address | San Antonio, TX 78258-3987 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 11/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
161127901 | (05) | TX |
7325464 | AETNA PIN# (01) | |
G83774 | (02) |