Individual
JULIE AVIVA MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9419 COMMON BROOK RD, SUITE 200, OWINGS MILLS, MD 21117-7536
(410) 484-9595
(410) 484-5139
Mailing address
9419 COMMON BROOK RD, SUITE 200, OWINGS MILLS, MD 21117-7536
(410) 484-9595
(410) 484-5139
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0005609
MD
Other
Enumeration date
10/28/2014
Last updated
07/25/2017
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