Provider Demographics
NPI:1902988256
Name:MACRAE, JULIA W (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:W
Last Name:MACRAE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:E62 OMEGA DR
Mailing Address - Street 2:OMEGA PROFESSIONAL CENTER
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-368-9611
Mailing Address - Fax:302-368-3424
Practice Address - Street 1:E62 OMEGA DR
Practice Address - Street 2:OMEGA PROFESSIONAL CENTER
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-368-9611
Practice Address - Fax:302-368-3424
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DECI00069292086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000030172Medicaid
DEG01532J01Medicare PIN
DE1000030172Medicaid