Provider Demographics
NPI:1841246485
Name:AI, JULIA (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:AI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6120 MAE ANNE AVE
Mailing Address - Street 2:1
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-4726
Mailing Address - Country:US
Mailing Address - Phone:775-746-0196
Mailing Address - Fax:855-873-0927
Practice Address - Street 1:6120 MAE ANNE AVE
Practice Address - Street 2:1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523
Practice Address - Country:US
Practice Address - Phone:775-746-0196
Practice Address - Fax:855-873-0927
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2018-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV11792207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV102824OtherMEDICARE
NV100510807Medicaid
NV100510807Medicaid