Provider Demographics
NPI:1578592275
Name:MONTEJO, JULIA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LYNN
Last Name:MONTEJO
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 1:9 VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2712
Mailing Address - Country:US
Mailing Address - Phone:978-256-4531
Mailing Address - Fax:978-256-1377
Practice Address - Street 1:9 VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2712
Practice Address - Country:US
Practice Address - Phone:978-256-4531
Practice Address - Fax:978-256-1377
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46049207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP39054OtherHEALTHPARTNERS
MN171819OtherUCARE MN #
MN7892445OtherAETNA INS
MN081K7MOOtherBCBS OF MN
MN1847598OtherAMERICA'S PPO
MN6606594OtherMEDICA UC #
MN0200175OtherMEDICA #
MN1034667OtherPREFERRED ONE
MN163437200Medicaid
MNH86235Medicare UPIN