Provider Demographics
NPI:1407499452
Name:ATEMAFAC, JULIUS (EDD, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:
Last Name:ATEMAFAC
Suffix:
Gender:M
Credentials:EDD, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 REXFORD WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13944 BALTIMORE AVE STE 102
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5000
Practice Address - Country:US
Practice Address - Phone:240-491-2868
Practice Address - Fax:866-207-0983
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176168207Q00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health