Provider Demographics
NPI:1003994633
Name:OLIN, JULIE JAE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JAE
Last Name:OLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 OLD PUMP RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-2741
Mailing Address - Country:US
Mailing Address - Phone:802-899-2195
Mailing Address - Fax:
Practice Address - Street 1:528 WASHINGTON HIGHWAY
Practice Address - Street 2:COPLEY HOSPITAL
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661
Practice Address - Country:US
Practice Address - Phone:802-888-8372
Practice Address - Fax:802-888-8131
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0007766207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology