Healthcare Provider Details

I. General information

NPI: 1639112477
Provider Name (Legal Business Name): JOSHUA H REAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23040 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32413-1107
US

IV. Provider business mailing address

23040 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32413-1107
US

V. Phone/Fax

Practice location:
  • Phone: 850-770-3230
  • Fax: 850-770-3235
Mailing address:
  • Phone: 850-770-3230
  • Fax: 850-770-3235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME118076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: