Provider Demographics
NPI:1740636125
Name:HARBAUGH, JOSHUA W (DO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:W
Last Name:HARBAUGH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:730 HIGHLAND OAKS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7108
Mailing Address - Country:US
Mailing Address - Phone:336-768-2425
Mailing Address - Fax:336-768-4915
Practice Address - Street 1:730 HIGHLAND OAKS DR STE 201
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7108
Practice Address - Country:US
Practice Address - Phone:336-768-2425
Practice Address - Fax:336-768-4915
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-00495207RN0300X, 207RN0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1740636125OtherNPI NUMBER