Provider Demographics
NPI:1871777292
Name:ULMER, CHAD WINFIELD (MD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:WINFIELD
Last Name:ULMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 W MARKET ST
Mailing Address - Street 2:APT. 901
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1009
Mailing Address - Country:US
Mailing Address - Phone:330-414-7717
Mailing Address - Fax:
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2433
Practice Address - Country:US
Practice Address - Phone:330-344-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.010615207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2936014Medicaid
OHUL4256383Medicare PIN
OH2936014Medicaid