Provider Demographics
NPI:1598046294
Name:MIKULAS, JULIE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:MIKULAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:BUSHWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:352 PINEO CT
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-3412
Mailing Address - Country:US
Mailing Address - Phone:330-497-9592
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist