Provider Demographics
NPI:1033244850
Name:NALL, JUEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:JUEL
Middle Name:R
Last Name:NALL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5044 SPRUCE ST
Mailing Address - Street 2:MEDNET HEALTHCARE SYSTEMS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4115
Mailing Address - Country:US
Mailing Address - Phone:215-474-4410
Mailing Address - Fax:215-474-4418
Practice Address - Street 1:5044 SPRUCE ST
Practice Address - Street 2:MEDNET HEALTHCARE SYSTEMS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-4115
Practice Address - Country:US
Practice Address - Phone:215-474-4410
Practice Address - Fax:215-474-4410
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2011-04-26
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Provider Licenses
StateLicense IDTaxonomies
PAMD070387L2084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology