MEDICARE: JOSHUA MCBRIDE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	9363320-1205	UT

General Provider Information

NPI Number	:	1053679027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA MCBRIDE M.D.

Provider Business Mailing Address
First Line	:	5682 S 3500 W STE A
Second Line	:
City	:	ROY
State	:	UT
Zip	:	84067-9108
Country	:	US
Telephone Number	:	801-773-8644
Fax Number	:	801-773-9828

Provider Business Practice Location Address
First Line	:	5682 S 3500 W STE A
Second Line	:
City	:	ROY
State	:	UT
Zip	:	84067-9108
Country	:	US
Telephone Number	:	801-773-8644
Fax Number	:	801-773-9828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	01/16/2025

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