Provider Demographics
NPI:1740683119
Name:DANESH, JULIUS A (MD)
Entity type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:A
Last Name:DANESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARASH
Other - Middle Name:
Other - Last Name:DANESH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:90 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-1648
Mailing Address - Country:US
Mailing Address - Phone:740-633-1100
Mailing Address - Fax:
Practice Address - Street 1:92 N 4TH ST STE 4
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1600
Practice Address - Country:US
Practice Address - Phone:740-633-4400
Practice Address - Fax:740-633-4403
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142150207R00000X, 208VP0000X
PAMT207455207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.142150OtherLICENSE