Provider Demographics
NPI:1780640680
Name:GREENHOE, JOSHUA MARKS (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:MARKS
Last Name:GREENHOE
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 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:434-654-8931
Practice Address - Street 1:590 PETER JEFFERSON PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4628
Practice Address - Country:US
Practice Address - Phone:434-654-8930
Practice Address - Fax:434-654-8931
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA174033OtherBLUE CROSS BLUE SHIELD
VA005825245Medicaid
VA174033OtherBLUE CROSS BLUE SHIELD
VA005825245Medicaid