MEDICARE: JOSHUA STREVELER MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1588304679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA STREVELER MD

Provider Business Mailing Address
First Line	:	2020 LORAIN AVE APT 525
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # JJ24
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-3428
Country	:	US
Telephone Number	:	800-223-2273
Fax Number	:

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

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	06/20/2023

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