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
Fax: (219) 267-1720
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376514950 NPPES
Indiana Other 01049022A INDIANA LICENSE
Indiana Other 01049022B INDIANA LICENSE
Indiana MEDICAID 200540460 INDIANA LICENSE

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