Provider Demographics
NPI:1679655047
Name:KOEHLER, JULIA R (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:R
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:300 LONGWOOD AVENUE
Mailing Address - Street 2:ENDERS 7
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2732
Mailing Address - Country:US
Mailing Address - Phone:617-919-2900
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-919-2900
Practice Address - Fax:617-730-0254
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2020-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1579182080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3181640Medicaid
G73620Medicare UPIN
MA3181640Medicaid