MEDICARE: DR. JOSHUA CHARLES GIORDANO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L2035491	MI

General Provider Information

NPI Number	:	1326326836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA CHARLES GIORDANO D.O.

Provider Business Mailing Address
First Line	:	21543 WOODBRIDGE ST
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-2324
Country	:	US
Telephone Number	:	586-489-9856
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 PINE GROVE AVE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-1944
Country	:	US
Telephone Number	:	810-989-2530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2011
Last Update Date	:	12/12/2019

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