=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528215340
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA MICHAEL DOWNIE M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2008
-----------------------------------------------------
Last Update Date | 10/19/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5670 PEACHTREE DUNWOODY RD STE 1280
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30342
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-257-1589
-----------------------------------------------------
Fax | 404-303-1950
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5670 PEACHTREE DUNWOODY RD STE 1280
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30342-4792
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-257-1589
-----------------------------------------------------
Fax | 404-303-1950
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | 65763
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------