Healthcare Provider Details

I. General information

NPI: 1679100127
Provider Name (Legal Business Name): JOSHUA JAMES HURLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MELVIN AVE STE 7A
ANNAPOLIS MD
21401-1515
US

IV. Provider business mailing address

700 MELVIN AVE STE 7A
ANNAPOLIS MD
21401-1515
US

V. Phone/Fax

Practice location:
  • Phone: 443-566-0724
  • Fax:
Mailing address:
  • Phone: 443-566-0724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0099491
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: