Provider Demographics
NPI:1619175411
Name:WONDERLING, JULIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:L
Last Name:WONDERLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:LOEFFLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:763 JOHNSONBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-3417
Mailing Address - Country:US
Mailing Address - Phone:814-788-8595
Mailing Address - Fax:814-788-8036
Practice Address - Street 1:ERPG EMERGENCY SERVICES
Practice Address - Street 2:763 JOHNSONBURG ROAD
Practice Address - City:ST. MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-3417
Practice Address - Country:US
Practice Address - Phone:814-788-8595
Practice Address - Fax:814-788-8036
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432128207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001970806OtherHIGHMARK INDIVIDUAL