Individual
MS. JULIA ANNETTE GRESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85338-2618
(623) 882-1500
Mailing address
1830 E ANCHOR DR, GILBERT, AZ 85234-4910
(480) 813-4614
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1620
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE GRP NUMBER
AZ
01
—
453051001
GROUP HEALTH GRP NUMBER
AZ
05
—
546301
—
AZ
01
—
860373636
HUMANA GROUP NUMBER
AZ
01
—
AW1436
HEALTHNET GRP NUMBER
AZ
Enumeration date
11/07/2005
Last updated
02/21/2014
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