Provider Demographics
NPI:1831178771
Name:JULKA, SURJIT SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:SURJIT
Middle Name:SINGH
Last Name:JULKA
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-583-8981
Mailing Address - Fax:
Practice Address - Street 1:821N EUTAW ST 407
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-6304
Practice Address - Country:US
Practice Address - Phone:410-669-1393
Practice Address - Fax:443-524-0749
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2015-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026395174400000X
MDD26395207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD794621000Medicaid
MD794621000Medicaid
MD224146ZCEAMedicare PIN
MD476LMedicare PIN
MDP01091147Medicare PIN