Healthcare Provider Details

I. General information

NPI: 1528298965
Provider Name (Legal Business Name): JULIE E. LEDGERWOOD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE E. MARTIN D.O.

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NIH 9000 ROCKVILLE PIKE CLINICAL RESEARCH CTR CRC BUILDING 10 ROOM 5-2440
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

NIH 9000 ROCKVILLE PIKE CLINICAL RESEARCH CTR CRC BUILDING 10 ROOM 5-2440
BETHESDA MD
20892-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-594-8502
  • Fax:
Mailing address:
  • Phone: 301-594-8502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberH0059386
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: