1437242518 NPI number — JULI V BREHM D.O.

Table of content: JULI V BREHM D.O. (NPI 1437242518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437242518 NPI number — JULI V BREHM D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BREHM
Provider First Name:
JULI
Provider Middle Name:
V
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHURDELL
Provider Other First Name:
JULI
Provider Other Middle Name:
V
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437242518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
252 RURAL ACRES DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BECKLEY
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25801-3503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
43-255-8555
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7127 HARPER ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLEN DANIEL
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-255-8555
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2006

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: 207Q00000X , with the licence number:  2042 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2141891 . This is a "UNITEDHEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59169 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00389009 . This is a "MEDICARE TRAVELERS RAILRO" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001783331 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3810004183 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32881 . This is a "CARELINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: I46343 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90454 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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