Provider Demographics
NPI:1114970654
Name:DEJULIUS, DENNIS P (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:P
Last Name:DEJULIUS
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 1:725 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2421
Mailing Address - Country:US
Mailing Address - Phone:330-434-4141
Mailing Address - Fax:
Practice Address - Street 1:725 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2421
Practice Address - Country:US
Practice Address - Phone:330-434-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067353207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0102847Medicaid
OH930052954OtherRR MEDICARE
OH61641OtherUNITED HEALTHCARE
OH61641OtherUNITED HEALTHCARE
OH34177922603OtherMED MUTUAL OH 2 OF 2
OH61641OtherUNITED HEALTHCARE
OH0102847Medicaid
OHF94756Medicare UPIN