Healthcare Provider Details

I. General information

NPI: 1689855181
Provider Name (Legal Business Name): DAVID I. JOSEPH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 R ST NW
WASHINGTON DC
20009-1031
US

IV. Provider business mailing address

1904 R ST NW
WASHINGTON DC
20009-1031
US

V. Phone/Fax

Practice location:
  • Phone: 202-265-3334
  • Fax: 301-656-0430
Mailing address:
  • Phone: 202-265-3334
  • Fax: 301-656-0430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5487
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: