Provider Demographics
NPI:1649212663
Name:ROMNEY, JOSHUA STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:STEVEN
Last Name:ROMNEY
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:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-464-7660
Mailing Address - Fax:801-464-7695
Practice Address - Street 1:2000 S 900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3208
Practice Address - Country:US
Practice Address - Phone:801-464-7660
Practice Address - Fax:801-464-7695
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT57615731205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT942854057090Medicaid
UTI53612Medicare UPIN
UT000059002Medicare PIN
UT000063598Medicare PIN