Healthcare Provider Details

I. General information

NPI: 1205192382
Provider Name (Legal Business Name): JULIA C WEST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MEDICAL CENTER DRIVE PULMONARY/CRITICAL CARE MEDICINE
LEBANON NH
03756-0001
US

IV. Provider business mailing address

ONE MEDICAL CENTER DRIVE PULMONARY/CRITICAL CARE MEDICINE
LEBANON NH
03756-0001
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5533
  • Fax:
Mailing address:
  • Phone: 603-650-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number19763
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number19763
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: