Provider Demographics
NPI:1760621809
Name:BREYER, JULIUS T
Entity Type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:T
Last Name:BREYER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JULIUS
Other - Middle Name:THOMAS
Other - Last Name:BREYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:34304 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-8732
Mailing Address - Country:US
Mailing Address - Phone:262-646-3999
Mailing Address - Fax:262-646-3999
Practice Address - Street 1:34304 SUNSET DR
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-8732
Practice Address - Country:US
Practice Address - Phone:262-646-3999
Practice Address - Fax:262-646-3999
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16673-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine