Provider Demographics
NPI:1124687876
Name:URIELL, EDWARD MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:MICHAEL
Last Name:URIELL
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 1:1607 AVENUE E APT 2
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3064
Mailing Address - Country:US
Mailing Address - Phone:701-247-3366
Mailing Address - Fax:
Practice Address - Street 1:1607 AVENUE E APT 2
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3064
Practice Address - Country:US
Practice Address - Phone:701-247-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019014128208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice