Provider Demographics
NPI:1639172174
Name:YAMAMOTO, JOSHUA SHIGERU (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:SHIGERU
Last Name:YAMAMOTO
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 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:STE 202
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3627
Mailing Address - Country:US
Mailing Address - Phone:202-243-0271
Mailing Address - Fax:202-537-0075
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:STE 202
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3627
Practice Address - Country:US
Practice Address - Phone:202-243-0271
Practice Address - Fax:202-537-0075
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035778207RC0000X
MDD0051320207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP01143959OtherRAILROAD MEDICARE
DCP01143959OtherRAILROAD MEDICARE
DC182141YKHAMedicare PIN
MDI46918Medicare UPIN
MDP00380583OtherRAILROAD MEDICARE
MD32331400Medicaid