Provider Demographics
NPI:1386677383
Name:DENNIS, JULIE M (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:DENNIS
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 1:3300 CAHABA RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2623
Mailing Address - Country:US
Mailing Address - Phone:205-870-7292
Mailing Address - Fax:205-870-3639
Practice Address - Street 1:3300 CAHABA RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2623
Practice Address - Country:US
Practice Address - Phone:205-870-7292
Practice Address - Fax:205-870-3639
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL23550208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00994550Medicaid
AL51506767OtherBLUE CROSS BLUE SHIELD
AL51506767OtherBLUE CROSS BLUE SHIELD