Provider Demographics
NPI:1063857167
Name:HUFF, JOSHUA DEWAYNE (SWIDC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DEWAYNE
Last Name:HUFF
Suffix:
Gender:M
Credentials:SWIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MELIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-4579
Mailing Address - Country:US
Mailing Address - Phone:808-723-0544
Mailing Address - Fax:
Practice Address - Street 1:33380 GYPSUM ST
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-7625
Practice Address - Country:US
Practice Address - Phone:951-348-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman