Provider Demographics
NPI:1700320819
Name:EVERHAM, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:EVERHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3076 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48748-9500
Mailing Address - Country:US
Mailing Address - Phone:720-485-1892
Mailing Address - Fax:
Practice Address - Street 1:41521 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1803
Practice Address - Country:US
Practice Address - Phone:248-299-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other