Individual
MR. JOSHUA JEREMIAH BEARDSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
103940
NC
363AS0400X
Surgical Physician Assistant
Primary
PA936
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00193752
RAILROAD MEDICARE
—
Enumeration date
07/15/2005
Last updated
01/12/2016
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