Healthcare Provider Details

I. General information

NPI: 1629050547
Provider Name (Legal Business Name): JULIE CURTIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 BLACK BURNIAN RD
WESTON MA
02493-1321
US

IV. Provider business mailing address

54 BLACK BURNIAN RD
WESTON MA
02493-1321
US

V. Phone/Fax

Practice location:
  • Phone: 781-736-9134
  • Fax:
Mailing address:
  • Phone: 781-736-9134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberME91665
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: