Provider Demographics
NPI:1164860078
Name:STRINGAM, JOSHUA TED (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TED
Last Name:STRINGAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 FAIR ST
Mailing Address - Street 2:
Mailing Address - City:BUHL
Mailing Address - State:ID
Mailing Address - Zip Code:83316-6442
Mailing Address - Country:US
Mailing Address - Phone:208-543-8271
Mailing Address - Fax:208-543-8272
Practice Address - Street 1:725 FAIR ST
Practice Address - Street 2:
Practice Address - City:BUHL
Practice Address - State:ID
Practice Address - Zip Code:83316-6442
Practice Address - Country:US
Practice Address - Phone:208-543-8271
Practice Address - Fax:208-543-8272
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191313207Q00000X
IDO-0898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1374811Medicare Oscar/Certification