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General NPI Number Information
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NPI Number | 1073542940
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Entity Type | Individual
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Provider Name | JULIE B TREDEMEYER DO
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Gender | Female
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 3505 S REED RD
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City | KOKOMO
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State | IN
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Zip | 46902-3838
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Country | US
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Telephone | 765-776-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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Country | US
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Telephone |
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 02005045A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101016715
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02005045A
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License Number State | IN
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