Provider Demographics
NPI:1295753440
Name:ADAMS, JULIE L (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:ADAMS
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 1:4101 N ROXBORO ST
Mailing Address - Street 2:COMMUNITY SUPPORT PROFESSIONALS,LLC
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2121
Mailing Address - Country:US
Mailing Address - Phone:919-620-4918
Mailing Address - Fax:
Practice Address - Street 1:4101 N ROXBORO ST
Practice Address - Street 2:COMMUNITY SUPPORT PROFESSIONALS,LLC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2121
Practice Address - Country:US
Practice Address - Phone:919-620-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-007632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904413Medicaid
NCI62261Medicare UPIN
NC5904413Medicaid