Provider Demographics
NPI:1770768152
Name:JULIE K. FOX, M.D., L.L.C.
Entity type:Organization
Organization Name:JULIE K. FOX, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-681-3667
Mailing Address - Street 1:2101 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-681-3667
Mailing Address - Fax:301-681-3677
Practice Address - Street 1:2101 MEDICAL PARK DR
Practice Address - Street 2:SUITE 301
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:301-681-3677
Practice Address - Fax:301-681-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA196433OtherRAILROAD MEDICARE
MD981300400Medicaid
MD981300400Medicaid