Provider Demographics
NPI:1831295286
Name:KRIVY, JULIE B
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:B
Last Name:KRIVY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8630 FENTON ST STE 1105
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3861
Practice Address - Country:US
Practice Address - Phone:301-681-9095
Practice Address - Fax:410-367-2114
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052069207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
0787143OtherAETNA
24324OtherMAMSI
4086234OtherUNITED HEALTH CARE
58030006OtherBLUE CROSS PC
CM6438OtherRAILROAD MEDICARE
KA62ITOtherBLUE CROSS MD
MD404759100Medicaid
012901Medicare ID - Type Unspecified
24324OtherMAMSI