Provider Demographics
NPI:1770584518
Name:JULIAN, THOMAS B (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:JULIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3336
Mailing Address - Fax:412-359-6263
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3336
Practice Address - Fax:412-359-6263
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019998E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000858031Medicaid
WV3810008429Medicaid
WV3810008429Medicaid
PA000858031Medicaid
PA1023018447Medicare PIN
WV3810008429Medicaid
PA070907NHYMedicare PIN