Healthcare Provider Details

I. General information

NPI: 1831550748
Provider Name (Legal Business Name): JOSHUA MACDAVID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2016
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 W CHARLESTON BLVD STE 190
LAS VEGAS NV
89102-2352
US

IV. Provider business mailing address

1701 W CHARLESTON BLVD STE 490-19
LAS VEGAS NV
89102-2325
US

V. Phone/Fax

Practice location:
  • Phone: 702-671-2273
  • Fax:
Mailing address:
  • Phone: 702-671-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number24589
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number24589
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: