Provider Demographics
NPI:1003073677
Name:KRULLA, JULIA LOTTIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LOTTIE
Last Name:KRULLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:LOTTIE
Other - Last Name:KAMINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4424 COSTELLO WAY
Mailing Address - Street 2:HAYMARKET PEDIATRICS
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169
Mailing Address - Country:US
Mailing Address - Phone:703-753-1895
Mailing Address - Fax:703-753-4630
Practice Address - Street 1:4424 COSTELLO WAY
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2996
Practice Address - Country:US
Practice Address - Phone:703-753-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243234208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics