Provider Demographics
NPI:1912008210
Name:JULIAN, CRAIG M (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:M
Last Name:JULIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2509
Mailing Address - Country:US
Mailing Address - Phone:508-473-1750
Mailing Address - Fax:508-473-1751
Practice Address - Street 1:296 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2509
Practice Address - Country:US
Practice Address - Phone:508-473-1750
Practice Address - Fax:508-473-1751
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36862OtherBCBS INDIV. PROV. #
RI23832-6OtherBCBS OF RI
MA351373OtherHARVARD PILGRIM
MA468675OtherTUFTS HEALTH PLAN
MAU86117Medicare UPIN
MAJUY45453Medicare ID - Type UnspecifiedINDIV. PROVIDER #