Provider Demographics
NPI:1457192007
Name:DEGUZMAN, JOSHUA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:DEGUZMAN
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 1:169 ASHLEY AVENUE
Mailing Address - Street 2:ROOM 202 MAIN HOSPITAL MSC333
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425
Mailing Address - Country:US
Mailing Address - Phone:843-792-2322
Mailing Address - Fax:
Practice Address - Street 1:167 ASHLEY AVENUE
Practice Address - Street 2:SUITE 301 MSC 912
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-9120
Practice Address - Country:US
Practice Address - Phone:843-792-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL92156207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology