Provider Demographics
NPI:1154613248
Name:WESP, JULIE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:WESP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 7TH ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3217
Mailing Address - Country:US
Mailing Address - Phone:510-393-5141
Mailing Address - Fax:
Practice Address - Street 1:1631 HOSPITAL DR STE 240
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7691
Practice Address - Country:US
Practice Address - Phone:505-913-3975
Practice Address - Fax:505-986-8001
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMMD2017-0708208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program