Provider Demographics
NPI:1912042557
Name:KNAS, JULIE RACE (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:RACE
Last Name:KNAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:RACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:37935 W 12 MILE RD STE A
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3035
Mailing Address - Country:US
Mailing Address - Phone:248-987-4877
Mailing Address - Fax:248-987-2159
Practice Address - Street 1:37935 W 12 MILE RD STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3035
Practice Address - Country:US
Practice Address - Phone:248-987-4877
Practice Address - Fax:248-987-2159
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009380103TC0700X
MI5101015420207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical