Provider Demographics
NPI:1265798417
Name:MACPHERSON, JULIE CHRISTINE (DO)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:CHRISTINE
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:CHRISTINE
Other - Last Name:GLEESING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4967 CROOKS RD
Mailing Address - Street 2:STE 250
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098
Mailing Address - Country:US
Mailing Address - Phone:248-654-6499
Mailing Address - Fax:833-985-2159
Practice Address - Street 1:4967 CROOKS RD
Practice Address - Street 2:STE 250
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098
Practice Address - Country:US
Practice Address - Phone:248-654-6499
Practice Address - Fax:833-985-2159
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101019850208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program