Provider Demographics
NPI:1518991306
Name:MEYERS, JULIE E (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:MEYERS
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 1:170 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6152
Mailing Address - Country:US
Mailing Address - Phone:508-421-6102
Mailing Address - Fax:
Practice Address - Street 1:UMASS MEDICAL SCHOOL
Practice Address - Street 2:100 CENTURY DRIVE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01613
Practice Address - Country:US
Practice Address - Phone:508-421-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics