Provider Demographics
NPI:1649218389
Name:EMDUR, JOSHUA A (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:A
Last Name:EMDUR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8300 ALCOTT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4030
Mailing Address - Country:US
Mailing Address - Phone:720-443-8461
Mailing Address - Fax:720-923-1223
Practice Address - Street 1:8300 ALCOTT ST STE 300
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031
Practice Address - Country:US
Practice Address - Phone:720-443-8461
Practice Address - Fax:720-923-1223
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9310207Q00000X
CODR.0046419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45522359Medicaid
COCOA104779Medicare PIN