Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D81507 | MD |
N | 208200000X | Surgeon | 125-056646 | IL |
N | 208600000X | Surgeon | 125-056646 | IL |
NPI | 1306074901 |
---|---|
Provider Name | Ulric Bigby |
First Address | Glen Burnie, MD 21061-6413 |
Second Address | Arnold, MD 21012-2706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 23/11/2021 |