1942725296 NPI number — MS. JULIA SOPHIE FRUH M.D.

Table of content: MS. JULIA SOPHIE FRUH M.D. (NPI 1942725296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942725296 NPI number — MS. JULIA SOPHIE FRUH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRUH
Provider First Name:
JULIA
Provider Middle Name:
SOPHIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRUEH
Provider Other First Name:
JULIA
Provider Other Middle Name:
SOPHIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1942725296
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
08/14/2018
NPI Reactivation Date:
08/27/2018

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 OAKLAND DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KALAMAZOO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-337-6400
Provider Business Mailing Address Fax Number:
269-337-6434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 OAKLAND DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KALAMAZOO
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-337-6400
Provider Business Practice Location Address Fax Number:
269-337-6434
Provider Enumeration Date:
08/08/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , with the licence number:  4351043239 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)