MEDICARE: JULIE LYNN CRUZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZB0001X	Blood Banking & Transfusion Medicine Physician	01060710A	IN

General Provider Information

NPI Number	:	1811231426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE LYNN CRUZ M.D.

Provider Business Mailing Address
First Line	:	3450 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4437
Country	:	US
Telephone Number	:	317-916-5009
Fax Number	:	317-916-5005

Provider Business Practice Location Address
First Line	:	3450 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4437
Country	:	US
Telephone Number	:	317-916-5009
Fax Number	:	317-916-5005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2012
Last Update Date	:	11/20/2012

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