Provider Demographics
NPI:1114458502
Name:FOROMERA, JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:FOROMERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 COBB PARKWAY NORTH NW STE 210B
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-4182
Mailing Address - Country:US
Mailing Address - Phone:470-267-1760
Mailing Address - Fax:
Practice Address - Street 1:4550 COBB PARKWAY NORTH NW STE 210B
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4182
Practice Address - Country:US
Practice Address - Phone:470-267-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94996207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology