Healthcare Provider Details

I. General information

NPI: 1306412911
Provider Name (Legal Business Name): JULIA YU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVE STE 3A
JACKSON MI
49201-1753
US

IV. Provider business mailing address

205 N EAST AVE STE 3A
JACKSON MI
49201-1753
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-4800
  • Fax:
Mailing address:
  • Phone: 313-874-4806
  • Fax: 313-876-1305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number4301517621
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: