Provider Demographics
NPI:1699031401
Name:VISGAUSS, JULIA DAWN (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:DAWN
Last Name:VISGAUSS
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 1:801 S STREEPER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3845
Mailing Address - Country:US
Mailing Address - Phone:631-252-6849
Mailing Address - Fax:
Practice Address - Street 1:200 TRENT DR
Practice Address - Street 2:DUKE CLINIC BUILDING, ROOM 5309
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3037
Practice Address - Country:US
Practice Address - Phone:919-684-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183093207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery