Healthcare Provider Details

I. General information

NPI: 1407018252
Provider Name (Legal Business Name): JULIE ANNA GREENWOOD D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 BROOK RD
RICHMOND VA
23227-1817
US

IV. Provider business mailing address

7406 BROOK RD
RICHMOND VA
23227-1817
US

V. Phone/Fax

Practice location:
  • Phone: 804-262-7153
  • Fax: 804-262-0104
Mailing address:
  • Phone: 804-262-7153
  • Fax: 804-262-0104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number0103301040
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberSC006055
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103301040
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006055
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: