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NPI Code Detail

MEDICARE: NICHOLAS ROBERT JULGA PA-C

MEDICARE:   NICHOLAS ROBERT JULGA  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant851-023WI

General Provider Information

NPI Number : 1174505333
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS ROBERT JULGA PA-C
Provider Business Mailing Address
First Line : 3077 N MAYFAIR RD STE 305
Second Line :
City : WAUWATOSA
State : WI
Zip : 53222-4305
Country : US
Telephone Number : 414-384-6700
Fax Number : 414-727-1058
Provider Business Practice Location Address
First Line : 3077 N MAYFAIR RD STE 305
Second Line :
City : WAUWATOSA
State : WI
Zip : 53222-4305
Country : US
Telephone Number : 414-384-6700
Fax Number : 414-727-1058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 03/20/2020

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Directions to “ NICHOLAS ROBERT JULGA PA-C” Practice Location

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