Healthcare Provider Details

I. General information

NPI: 1831178771
Provider Name (Legal Business Name): SURJIT SINGH JULKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 10/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821N EUTAW ST 407
BALTIMORE MD
21201-6304
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 410-669-1393
  • Fax: 443-524-0749
Mailing address:
  • Phone: 410-583-8981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0026395
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD26395
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: