Provider Demographics
NPI:1518536853
Name:PAUL, JOSHUA ADAM (LMT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ADAM
Last Name:PAUL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 BELLFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1711
Mailing Address - Country:US
Mailing Address - Phone:443-605-2884
Mailing Address - Fax:
Practice Address - Street 1:1603 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4960
Practice Address - Country:US
Practice Address - Phone:667-888-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM06232225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist