Provider Demographics
NPI:1467214148
Name:MEDINA DE JESUS, JOSHUA ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALEXANDER
Last Name:MEDINA DE JESUS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 E MARKET ST FL 7
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6608
Mailing Address - Country:US
Mailing Address - Phone:330-759-2511
Mailing Address - Fax:
Practice Address - Street 1:1350 E MARKET ST FL 7
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6608
Practice Address - Country:US
Practice Address - Phone:330-759-2511
Practice Address - Fax:330-841-9645
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program