Provider Demographics
NPI:1508186404
Name:EAGER, JOULIANA (DO)
Entity Type:Individual
Prefix:DR
First Name:JOULIANA
Middle Name:
Last Name:EAGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3081
Mailing Address - Country:US
Mailing Address - Phone:248-783-7060
Mailing Address - Fax:833-979-0932
Practice Address - Street 1:1177 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3081
Practice Address - Country:US
Practice Address - Phone:248-783-7060
Practice Address - Fax:833-979-0932
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-011394207R00000X
MI5101018814207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI5752071OtherMEDICARE
MI1508186404Medicaid
OHH329481Medicare PIN