Provider Demographics
NPI:1043313919
Name:ULERY, JAMES MARTIN JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARTIN
Last Name:ULERY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:315 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-4393
Mailing Address - Country:US
Mailing Address - Phone:734-457-4400
Mailing Address - Fax:734-242-8017
Practice Address - Street 1:315 STEWART RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-4393
Practice Address - Country:US
Practice Address - Phone:734-457-4400
Practice Address - Fax:734-242-8017
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJU063597207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICL2256OtherGROUP RAILROAD MEDICARE
MI070E81188-0OtherBCBSM NEW GROUP
MI0E81006OtherBCBS MI
MI0M19200Medicare ID - Type Unspecified
MI070812898Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MICL2256OtherGROUP RAILROAD MEDICARE