Provider Demographics
NPI:1770662462
Name:JULIEN, PAUL M (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:JULIEN
Suffix:
Gender:M
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:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855
Mailing Address - Country:US
Mailing Address - Phone:802-334-9009
Mailing Address - Fax:802-334-9022
Practice Address - Street 1:189 PROUTY DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9326
Practice Address - Country:US
Practice Address - Phone:802-334-3262
Practice Address - Fax:802-334-9022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420010859207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011153Medicaid
VT68401OtherBCBS VT
NH30205421OtherMEAID NH
VT1011153Medicaid
VTJUVN3627Medicare ID - Type Unspecified