MEDICARE: JULIA GATES 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
1	363AM0700X	Medical Physician Assistant	MA003539L	PA

General Provider Information

NPI Number	:	1255471751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA GATES PA-C

Provider Business Mailing Address
First Line	:	PO BOX 329
Second Line	:
City	:	EXTON
State	:	PA
Zip	:	19341-0329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 HOPEWELL RD
Second Line	:
City	:	DOWNINGTOWN
State	:	PA
Zip	:	19335-1047
Country	:	US
Telephone Number	:	610-269-9448
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/08/2007

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