Provider Demographics
NPI:1720006851
Name:DR JULIE JURD PC
Entity Type:Organization
Organization Name:DR JULIE JURD PC
Other - Org Name:PROGRESSIVE PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:JURD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-874-9669
Mailing Address - Street 1:3280 URBANA PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:URBANA
Mailing Address - State:MD
Mailing Address - Zip Code:21754
Mailing Address - Country:US
Mailing Address - Phone:301-874-9669
Mailing Address - Fax:301-829-9602
Practice Address - Street 1:3280 URBANA PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:URBANA
Practice Address - State:MD
Practice Address - Zip Code:21754
Practice Address - Country:US
Practice Address - Phone:301-874-9669
Practice Address - Fax:301-829-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01115213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5967210001Medicare NSC