Provider Demographics
NPI:1003028093
Name:BEARD, JULIE M (DO)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:BEARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 A AVENUE
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3026
Mailing Address - Country:US
Mailing Address - Phone:319-368-5976
Mailing Address - Fax:319-368-5932
Practice Address - Street 1:1026 A AVENUE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3026
Practice Address - Country:US
Practice Address - Phone:319-369-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS27530459649207PH0002X
IA3988207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00740854OtherRR MEDICARE MEMBER