Provider Demographics
NPI:1205544996
Name:DAMMAN, JULIA (RDN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DAMMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31250 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1357
Mailing Address - Country:US
Mailing Address - Phone:248-633-3620
Mailing Address - Fax:
Practice Address - Street 1:160 N WACKER DR UNIT 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1633
Practice Address - Country:US
Practice Address - Phone:855-552-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86326474OtherCOMMISSION ON DIETETIC REGISTRATION (CDR)