Healthcare Provider Details

I. General information

NPI: 1588635205
Provider Name (Legal Business Name): JOSHUA DAVID HARTZELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLD 7, INFECTIOUS DISEASES CLINIC 8901 ROCKVILLE PIKE
BETHESDA MD
20889-0003
US

IV. Provider business mailing address

11912 LEDGEROCK CT
POTOMAC MD
20854-2155
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-6295
  • Fax:
Mailing address:
  • Phone: 240-351-4415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101236543
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101236543
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: