Provider Demographics
NPI:1639188113
Name:SIMONE, JULIANNE (DO)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:SIMONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1519
Mailing Address - Country:US
Mailing Address - Phone:207-989-0550
Mailing Address - Fax:207-989-0551
Practice Address - Street 1:234 STATE ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1519
Practice Address - Country:US
Practice Address - Phone:207-989-0550
Practice Address - Fax:207-989-0551
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1307207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010474554OtherMEDNET
ME1044146OtherAETNA
MEM61751OtherCIGNA
ME288670099Medicaid
MEE69470OtherHARVARD PILGRIM
ME007621OtherANTHEM BC BS
MEE69470OtherHARVARD PILGRIM
MEE69470Medicare UPIN