Healthcare Provider Details

I. General information

NPI: 1558346361
Provider Name (Legal Business Name): JULIA M PILLSBURY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 GREENTREE DR STE 1
DOVER DE
19904-7656
US

IV. Provider business mailing address

125 GREENTREE DR
DOVER DE
19904-7656
US

V. Phone/Fax

Practice location:
  • Phone: 302-264-9386
  • Fax: 302-883-2588
Mailing address:
  • Phone: 302-264-9386
  • Fax: 302-883-2588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC20003240
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberC20003240
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: