Healthcare Provider Details

I. General information

NPI: 1316227150
Provider Name (Legal Business Name): JOSHUA DEARING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 07/21/2022
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7503 SURRATTS RD STE 208
CLINTON MD
20735-3358
US

IV. Provider business mailing address

7503 SURRATTS RD STE 208
CLINTON MD
20735-3358
US

V. Phone/Fax

Practice location:
  • Phone: 919-265-3311
  • Fax:
Mailing address:
  • Phone: 919-265-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD043369
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberD83184
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: