Provider Demographics
NPI:1053163402
Name:ULRICH, GARY LAWRENCE JR (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:LAWRENCE
Last Name:ULRICH
Suffix:JR
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 1:81 ALLENDALE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4751
Mailing Address - Country:US
Mailing Address - Phone:812-229-9003
Mailing Address - Fax:
Practice Address - Street 1:P.O. BOX 68-30705
Practice Address - Street 2:
Practice Address - City:KAPSOWAR
Practice Address - State:ELGEYO MARAKWET COUNTY
Practice Address - Zip Code:30705
Practice Address - Country:KE
Practice Address - Phone:079-841-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program