Provider Demographics
NPI:1689628265
Name:ISRAEL, JOSHUA A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:A
Last Name:ISRAEL
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 1:4550 MONTGOMERY AVE STE 950N
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3339
Mailing Address - Country:US
Mailing Address - Phone:202-847-8167
Mailing Address - Fax:
Practice Address - Street 1:4550 MONTGOMERY AVE STE 950N
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3339
Practice Address - Country:US
Practice Address - Phone:202-847-8167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA689442084P0800X
MDD00820762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A689440Medicaid
CA00A689440Medicare PIN
CAG64205Medicare UPIN