Provider Demographics
NPI:1205560851
Name:AUSAR, JULIAN
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:AUSAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 DELISA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2647
Mailing Address - Country:US
Mailing Address - Phone:702-538-2969
Mailing Address - Fax:
Practice Address - Street 1:7014 DELISA DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-2647
Practice Address - Country:US
Practice Address - Phone:702-538-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty