Provider Demographics
NPI:1437242518
Name:BREHM, JULI V (DO)
Entity Type:Individual
Prefix:
First Name:JULI
Middle Name:V
Last Name:BREHM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULI
Other - Middle Name:V
Other - Last Name:SCHURDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:RAVENCLIFF
Mailing Address - State:WV
Mailing Address - Zip Code:25913-0214
Mailing Address - Country:US
Mailing Address - Phone:304-294-8133
Mailing Address - Fax:304-294-8134
Practice Address - Street 1:RT 1
Practice Address - Street 2:
Practice Address - City:RAVENCLIFF
Practice Address - State:WV
Practice Address - Zip Code:25913
Practice Address - Country:US
Practice Address - Phone:304-294-8133
Practice Address - Fax:304-294-8134
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004183Medicaid
WVP00389009OtherMEDICARE TRAVELERS RAILRO
WV90454Medicaid
I46343OtherHEALTH NET
2141891OtherUNITEDHEALTHCARE
32881OtherCARELINK
WV59169Medicaid
WV90454Medicaid
WVBR2027152Medicare ID - Type Unspecified
I46343OtherHEALTH NET
I46343Medicare UPIN