Provider Demographics
NPI:1780097113
Name:PLUMMER, JOSHUA ALLEN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALLEN
Last Name:PLUMMER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6612 LATROBE FLS
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6624
Mailing Address - Country:US
Mailing Address - Phone:301-514-4949
Mailing Address - Fax:443-632-0521
Practice Address - Street 1:7468 CANDLEWOOD RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-3211
Practice Address - Country:US
Practice Address - Phone:301-514-4949
Practice Address - Fax:443-632-0521
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD25008OtherPT LICENSE