Healthcare Provider Details

I. General information

NPI: 1477849859
Provider Name (Legal Business Name): JULIA C FRITZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 CONGRESS ST
PORTLAND ME
04102-3100
US

IV. Provider business mailing address

887 CONGRESS ST
PORTLAND ME
04102-3100
US

V. Phone/Fax

Practice location:
  • Phone: 207-662-5522
  • Fax: 207-662-5526
Mailing address:
  • Phone: 207-662-5522
  • Fax: 207-662-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD21612
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberMD21612
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: