Provider Demographics
NPI:1497940571
Name:FELT, JULIE JEANETTE (MD,MMM)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JEANETTE
Last Name:FELT
Suffix:
Gender:F
Credentials:MD,MMM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:866-611-1512
Mailing Address - Fax:231-728-4789
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 201A
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-672-7800
Practice Address - Fax:231-672-7801
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1497940517Medicaid