Provider Demographics
NPI:1366647893
Name:ALMEYDA, JULIO ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:ENRIQUE
Last Name:ALMEYDA
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:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:EAGLE BUTTE
Mailing Address - State:SD
Mailing Address - Zip Code:57625-1155
Mailing Address - Country:US
Mailing Address - Phone:606-964-6165
Mailing Address - Fax:605-964-6165
Practice Address - Street 1:24276 166 ST AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:EAGLE BUTTE
Practice Address - State:SD
Practice Address - Zip Code:57625-1155
Practice Address - Country:US
Practice Address - Phone:605-964-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR009384208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF08088Medicare UPIN