Provider Demographics
NPI:1780388439
Name:MARTINEZ-SCHONTHALER, JULIANA GABRIELLE (DO)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:GABRIELLE
Last Name:MARTINEZ-SCHONTHALER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:GABRIELLE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:139 A. W. WILLIS AVE
Mailing Address - Street 2:UNIT #6-211
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103
Mailing Address - Country:US
Mailing Address - Phone:865-223-0604
Mailing Address - Fax:
Practice Address - Street 1:920 MADISON AVE STE 447
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3438
Practice Address - Country:US
Practice Address - Phone:901-448-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program