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General NPI Number Information
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NPI Number | 1003073677
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Entity Type | Individual
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Provider Name | JULIA LOTTIE KRULLA MD
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Gender | Female
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 4424 COSTELLO WAY
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City | HAYMARKET
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State | VA
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Zip | 20169-2996
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Country | US
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Telephone | 703-753-1895
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Fax |
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Provider Business Mailing Address
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Address Line | 4424 COSTELLO WAY HAYMARKET PEDIATRICS
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City | HAYMARKET
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State | VA
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Zip | 20169
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Country | US
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Telephone | 703-753-1895
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Fax | 703-753-4630
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101243234
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License Number State | VA
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