Provider Demographics
NPI:1649565227
Name:WINTJE, JOSHUA PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:PAUL
Last Name:WINTJE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSHUA
Other - Middle Name:P
Other - Last Name:WINTJE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5183 S LAREDO WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4151
Mailing Address - Country:US
Mailing Address - Phone:706-224-0692
Mailing Address - Fax:318-225-8243
Practice Address - Street 1:5183 S LAREDO WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-4151
Practice Address - Country:US
Practice Address - Phone:706-224-0692
Practice Address - Fax:318-225-8243
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO54528207R00000X
CODR.0054528207R00000X, 208M00000X
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90523831Medicaid
CO90523831Medicaid