Provider Demographics
NPI:1023283652
Name:SHOTT, JULIE Z (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:Z
Last Name:SHOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:ZWIESLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:231 SEASONS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44224
Mailing Address - Country:US
Mailing Address - Phone:330-971-7571
Mailing Address - Fax:330-255-5093
Practice Address - Street 1:231 SEASONS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44224
Practice Address - Country:US
Practice Address - Phone:330-971-7571
Practice Address - Fax:330-255-5093
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.089577207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3048259Medicaid