Provider Demographics
NPI:1679671325
Name:KROVIAK, JULIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:KROVIAK
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 1:6940 S KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3344
Mailing Address - Country:US
Mailing Address - Phone:703-313-0694
Mailing Address - Fax:
Practice Address - Street 1:6940 S KINGS HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3344
Practice Address - Country:US
Practice Address - Phone:703-313-0694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33440207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine