Provider Demographics
NPI:1578518809
Name:WINSTON, JULIE BETH (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BETH
Last Name:WINSTON
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 1:120 SISTER PIERRE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7525
Mailing Address - Country:US
Mailing Address - Phone:410-216-4945
Mailing Address - Fax:410-584-2241
Practice Address - Street 1:120 SISTER PIERRE DR STE 202
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7525
Practice Address - Country:US
Practice Address - Phone:410-216-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD35344207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD486961300Medicaid
MD158050ZR0ZMedicare PIN
MD486961300Medicaid
MDE94073Medicare UPIN
MD157676Medicare PIN
MDH596CE63Medicare PIN