Provider Demographics
NPI:1134419252
Name:THADEN, JOSHUA THOMAS (MD/PHD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:THOMAS
Last Name:THADEN
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 E CONCORD ST
Mailing Address - Street 2:BOX 932
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2307
Mailing Address - Country:US
Mailing Address - Phone:617-638-5300
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIRCLE
Practice Address - Street 2:CLINIC 1K
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-668-3197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-00352207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease