Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 892 | NE |
NPI | 1003137647 |
---|---|
Provider Name | Dr. Joshua C Storey |
First Address | Apo, AE 09720-7745 |
Second Address | Apo, AE 09720-7745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 07/08/2013 |