Provider Demographics
NPI:1881916898
Name:SCHOURUP, JULIE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:SCHOURUP
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BISBEE
Mailing Address - State:AZ
Mailing Address - Zip Code:85603-1257
Mailing Address - Country:US
Mailing Address - Phone:520-432-6065
Mailing Address - Fax:520-432-6728
Practice Address - Street 1:108 2ND ST
Practice Address - Street 2:
Practice Address - City:BISBEE
Practice Address - State:AZ
Practice Address - Zip Code:85603-1257
Practice Address - Country:US
Practice Address - Phone:520-432-6065
Practice Address - Fax:520-432-6728
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ415012083P0901X
CAG725462083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine