Provider Demographics
NPI:1790781474
Name:OVERHOLTZER, JULIE F (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:F
Last Name:OVERHOLTZER
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:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:
Practice Address - Street 1:6201 CENTREVILLE RD
Practice Address - Street 2:STE 100
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2626
Practice Address - Country:US
Practice Address - Phone:703-263-9600
Practice Address - Fax:703-266-1452
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101045155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA286087OtherANTHEM
VA5619076Medicaid
VA286087OtherANTHEM
VA00A357F22Medicare ID - Type Unspecified