Individual
MR. JOSHUA JOHN WHITE
Active
Individual
MR. JOSHUA JOHN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
3618
GA
363AM0700X
Medical Physician Assistant
Primary
2096
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002112A
—
GA
05
—
41937200
—
WI
01
—
450030728
MEDICARE PTAN
WI
01
—
711290124
MEDICARE PTAN
WI
01
—
WI2257002
MEDICARE PTAN
WI
Enumeration date
04/26/2006
Last updated
02/02/2015
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