Provider Demographics
NPI:1609840842
Name:STANTON, JULIE M (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:STANTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:234 RUSSELL ST
Mailing Address - Street 2:#7
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-3534
Mailing Address - Country:US
Mailing Address - Phone:413-586-6020
Mailing Address - Fax:413-584-0286
Practice Address - Street 1:234 RUSSELL ST
Practice Address - Street 2:#7
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3534
Practice Address - Country:US
Practice Address - Phone:413-586-6020
Practice Address - Fax:413-584-0286
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2010-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA54049207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-3194547OtherCONSOLIDATED
MA04-3194547OtherPLAN VISTA
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA20408OtherHEALTH NEW ENGLAND
MAJ11767OtherBCBSMA
MA04-3194547OtherPRIVATE HEALTHCARE
MA719454OtherCONNECTICARE
MA054049OtherTUFTS
MA000000007920OtherBMC
MA04-3194547OtherGREAT-WEST
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA3043339Medicaid
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherUNICARE/GIC
MA04-3194547OtherUNITED HEALTHCARE
MD1024100OtherCIGNA
MA2358690OtherAETNA
MA71797OtherHARVARD PILGRIM
MA71797OtherHARVARD PILGRIM
F04265Medicare UPIN