Provider Demographics
NPI:1689379638
Name:EVANS, JULIA MARIA (MEDICAL STUDENT, MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIA
Last Name:EVANS
Suffix:
Gender:F
Credentials:MEDICAL STUDENT, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 HIGHLAND LAKES DR
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-1403
Mailing Address - Country:US
Mailing Address - Phone:419-235-2355
Mailing Address - Fax:
Practice Address - Street 1:126 HIGHLAND LAKES DR
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-1403
Practice Address - Country:US
Practice Address - Phone:419-235-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program