Provider Demographics
NPI:1467650788
Name:PAN, JULLIE W (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JULLIE
Middle Name:W
Last Name:PAN
Suffix:
Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:3471 5TH AVE STE 811
Mailing Address - Street 2:UNIVERSITY OF PITTSBURGH
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3232
Mailing Address - Country:US
Mailing Address - Phone:412-692-4920
Mailing Address - Fax:412-692-4907
Practice Address - Street 1:3471 5TH AVE STE 811
Practice Address - Street 2:UNIVERSITY OF PITTSBURGH
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3232
Practice Address - Country:US
Practice Address - Phone:412-692-4920
Practice Address - Fax:412-692-4907
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0447412084N0400X
NY2133142084N0400X
PA4478392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology