Provider Demographics
NPI:1548335177
Name:FRASER, JULIE CATHERINE (DPM)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:CATHERINE
Last Name:FRASER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE I
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4895
Mailing Address - Country:US
Mailing Address - Phone:301-668-9707
Mailing Address - Fax:301-668-4927
Practice Address - Street 1:75 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE I
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4895
Practice Address - Country:US
Practice Address - Phone:301-668-9707
Practice Address - Fax:301-668-4927
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01452213ES0103X, 213ES0131X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD399PQ053Medicare PIN
MDN12433Medicare UPIN