Provider Demographics
NPI:1023073582
Name:PEASE, JULIE K (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:PEASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 BATH RD # 1
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2673
Mailing Address - Country:US
Mailing Address - Phone:207-373-3040
Mailing Address - Fax:207-373-3030
Practice Address - Street 1:329 BATH RD # 1
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2673
Practice Address - Country:US
Practice Address - Phone:207-373-3040
Practice Address - Fax:207-373-3030
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME123522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME330660099Medicaid
ME330660099Medicaid