Provider Demographics
NPI:1487765004
Name:SHINER, JULIA W (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:W
Last Name:SHINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8200 JONES BRANCH DR
Mailing Address - Street 2:ROOM 1317 MS 111
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3107
Mailing Address - Country:US
Mailing Address - Phone:703-903-2844
Mailing Address - Fax:703-903-2803
Practice Address - Street 1:8200 JONES BRANCH DR
Practice Address - Street 2:ROOM 1317 MS 111
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3107
Practice Address - Country:US
Practice Address - Phone:703-903-2844
Practice Address - Fax:703-903-2803
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101102805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
009303I11Medicare ID - Type Unspecified
H15496Medicare UPIN