Provider Demographics
NPI:1104438183
Name:NAUMANN, JOSHUA PATRICK (RD)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:PATRICK
Last Name:NAUMANN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 MAES CT
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7129
Mailing Address - Country:US
Mailing Address - Phone:443-974-2648
Mailing Address - Fax:
Practice Address - Street 1:11270 PEPPER RD
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1202
Practice Address - Country:US
Practice Address - Phone:410-771-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86098863133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered