Healthcare Provider Details

I. General information

NPI: 1720241045
Provider Name (Legal Business Name): JULIE ELIZABETH FURLAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 WHITTIER HIGHWAY MOULTONBOROUGH FAMILY MEDICINE
MOULTONBOROUGH NH
03254
US

IV. Provider business mailing address

984 WHITTIER HWY
MOULTONBOROUGH NH
03254-3305
US

V. Phone/Fax

Practice location:
  • Phone: 603-476-2216
  • Fax: 603-476-5396
Mailing address:
  • Phone: 603-476-2216
  • Fax: 603-476-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL1161
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15185
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: