Provider Demographics
NPI:1306309323
Name:ESSWEIN, JULIA E (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:E
Last Name:ESSWEIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-286-2080
Mailing Address - Fax:314-286-2085
Practice Address - Street 1:1044 N MASON RD
Practice Address - Street 2:DIV IM GERIATRIC MED, STE 330
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6431
Practice Address - Country:US
Practice Address - Phone:314-286-2080
Practice Address - Fax:314-286-2085
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2023011313207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200126431Medicaid