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NPI Code Detail

MEDICARE: JULIANA THEREZINHA FAJOSES SOTHERLAND M.D.

MEDICARE:   JULIANA THEREZINHA FAJOSES SOTHERLAND  M.D.
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
1207R00000XInternal Medicine PhysicianMD468840PA

General Provider Information

NPI Number : 1649630302
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIANA THEREZINHA FAJOSES SOTHERLAND M.D.
Provider Business Mailing Address
First Line : 400 S GREENWOOD AVE
Second Line :
City : EASTON
State : PA
Zip : 18045-3776
Country : US
Telephone Number : 484-822-5205
Fax Number :
Provider Business Practice Location Address
First Line : 400 S GREENWOOD AVE
Second Line :
City : EASTON
State : PA
Zip : 18045-3776
Country : US
Telephone Number : 484-822-5205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2016
Last Update Date : 10/22/2019

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Directions to “ JULIANA THEREZINHA FAJOSES SOTHERLAND M.D.” Practice Location

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