Individual
JULIAN DAVID WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 LAKE CONCORD RD NE, CONCORD, NC 28025-2918
(704) 792-2672
(704) 792-2674
Mailing address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
(704) 335-8448
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2017-01920
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659631984
—
NC
Enumeration date
05/21/2012
Last updated
03/20/2024
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