Provider Demographics
NPI:1942725296
Name:FRUH, JULIA SOPHIE (MD)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:SOPHIE
Last Name:FRUH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:SOPHIE
Other - Last Name:FRUEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1000 OAKLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008
Mailing Address - Country:US
Mailing Address - Phone:269-337-6400
Mailing Address - Fax:269-337-6434
Practice Address - Street 1:1000 OAKLAND DRIVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008
Practice Address - Country:US
Practice Address - Phone:269-337-6400
Practice Address - Fax:269-337-6434
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2019-02-12
Deactivation Date:2018-08-14
Deactivation Code:
Reactivation Date:2018-08-27
Provider Licenses
StateLicense IDTaxonomies
MI4351043239390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program