Provider Demographics
NPI: | 1932519287 |
---|---|
Name: | CLAUNCH, JOSHUA DANIEL (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | JOSHUA |
Middle Name: | DANIEL |
Last Name: | CLAUNCH |
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: | 571 BOSTON TPKE STE 3 |
Mailing Address - Street 2: | |
Mailing Address - City: | SHREWSBURY |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01545-5977 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 508-815-7284 |
Mailing Address - Fax: | 314-784-9836 |
Practice Address - Street 1: | 1 KNOLLWOOD DR |
Practice Address - Street 2: | |
Practice Address - City: | WORCESTER |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01609-1203 |
Practice Address - Country: | US |
Practice Address - Phone: | 508-815-7284 |
Practice Address - Fax: | 314-784-9836 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2014-05-07 |
Last Update Date: | 2024-05-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | 277874 | 2084B0040X, 2084P0800X, 2084N0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No | 2084B0040X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |