Provider Demographics
NPI:1518939438
Name:O'BRIEN, JULIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:E
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 SPOTSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2637
Mailing Address - Country:US
Mailing Address - Phone:540-604-9500
Mailing Address - Fax:540-604-9501
Practice Address - Street 1:10600 SPOTSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2637
Practice Address - Country:US
Practice Address - Phone:540-604-9500
Practice Address - Fax:540-604-9501
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36128208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01361286Medicaid
CO536018Medicare ID - Type Unspecified
CO01361286Medicaid