Healthcare Provider Details

I. General information

NPI: 1790351468
Provider Name (Legal Business Name): JOSEPH DAVID NATHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 WHITE OAK ST
ASHEBORO NC
27203-5434
US

IV. Provider business mailing address

9523 SW 65TH PL
OCALA FL
34481-2639
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-5151
  • Fax:
Mailing address:
  • Phone: 954-830-6196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2025-03710
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: