Provider Demographics
NPI:1194842120
Name:NEWMAN-TOKER, JULIE RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:RAE
Last Name:NEWMAN-TOKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5704 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1316
Mailing Address - Country:US
Mailing Address - Phone:410-323-2796
Mailing Address - Fax:410-323-6671
Practice Address - Street 1:2002 CLIPPER PARK RD
Practice Address - Street 2:AT AVALON WELLNESS, SUITE 110
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1405
Practice Address - Country:US
Practice Address - Phone:410-235-9539
Practice Address - Fax:410-889-8971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00560082084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG65752Medicare UPIN