Provider Demographics
NPI:1811421423
Name:BOATMAN, JULIE DANIELLE (DO)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:DANIELLE
Last Name:BOATMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DANIELLE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-675-5000
Mailing Address - Fax:804-675-5318
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:804-675-5318
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102207327207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease