Healthcare Provider Details

I. General information

NPI: 1770676306
Provider Name (Legal Business Name): JULIE MARIE OHNEMUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 FOSTER AVE
ARCATA CA
95521-5986
US

IV. Provider business mailing address

670 NINTH STREET SUITE 203
ARCATA CA
95521
US

V. Phone/Fax

Practice location:
  • Phone: 707-826-8610
  • Fax: 707-826-8623
Mailing address:
  • Phone: 707-826-8633
  • Fax: 707-826-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG66596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: