Healthcare Provider Details

I. General information

NPI: 1932367034
Provider Name (Legal Business Name): JULIA M REDDING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA M BELL DO

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 BRAMHALL ST
PORTLAND ME
04102-3344
US

IV. Provider business mailing address

301C US ROUTE 1
SCARBOROUGH ME
04074-9701
US

V. Phone/Fax

Practice location:
  • Phone: 207-662-3157
  • Fax: 207-662-4257
Mailing address:
  • Phone: 207-396-8600
  • Fax: 207-396-8632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number2316
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2316
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: