Provider Demographics
NPI:1447740675
Name:PUZZO, JULIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:PUZZO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ALDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1638 OWEN DR # 138
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3424
Mailing Address - Country:US
Mailing Address - Phone:910-615-5095
Mailing Address - Fax:910-615-9872
Practice Address - Street 1:1638 OWEN DR # 138
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:910-615-5095
Practice Address - Fax:910-615-9872
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2021-03000207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty