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NPI Code Detail

MEDICARE: JULIEANNE HLAVAC MD

MEDICARE: JULIEANNE HLAVAC MD
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
1207Q00000XFamily Medicine PhysicianMD420460PA

General Provider Information

NPI Number : 1235179714
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIEANNE HLAVAC MD
Provider Business Mailing Address
First Line : 1601 CHERRY ST
Second Line : SUITE 11511
City : PHILADELPHIA
State : PA
Zip : 19102-1321
Country : US
Telephone Number : 215-255-7822
Fax Number : 215-255-7825
Provider Business Practice Location Address
First Line : 10 SHURS LN
Second Line : SUITE 203
City : PHILADELPHIA
State : PA
Zip : 19127-2123
Country : US
Telephone Number : 215-482-1234
Fax Number : 215-482-0465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 08/13/2007

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