Derosa, Julie Ann
Derosa, Julie Ann is an individual health care provider with primary practice located at 10090 Georgia Street, Suite #3 , Crown Point IN 46307. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Derosa, Julie Ann can be contacted via phone (219) 472-4077.Contact Information
Primary practice address
10090 Georgia Street, Suite #3
Crown Point IN 46307
Phone: (219) 472-4077
Fax: (219) 267-1720
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01049022A | Indiana |
Profile Details
NPI number | 1376514950 |
---|---|
LBN Legal business name | Derosa, Julie Ann |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 31st, 2006 |
Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1376514950 | NPPES |
Indiana | Other | 01049022A | INDIANA LICENSE |
Indiana | Other | 01049022B | INDIANA LICENSE |
Indiana | MEDICAID | 200540460 | INDIANA LICENSE |
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