Provider Demographics
NPI:1770058042
Name:WAINHAUS, JOSHUA (PA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WAINHAUS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 MARNAT RD APT C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2429
Mailing Address - Country:US
Mailing Address - Phone:443-826-5923
Mailing Address - Fax:
Practice Address - Street 1:5 BEL AIR SOUTH PKWY STE 1535
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-3816
Practice Address - Country:US
Practice Address - Phone:410-569-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant