Provider Demographics
NPI:1316502966
Name:FEEMSTER, JOSHUA LEWIS
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LEWIS
Last Name:FEEMSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 TRYON SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BESSEMER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28016-7610
Mailing Address - Country:US
Mailing Address - Phone:704-616-4838
Mailing Address - Fax:
Practice Address - Street 1:1046 TRYON SCHOOL RD
Practice Address - Street 2:
Practice Address - City:BESSEMER CITY
Practice Address - State:NC
Practice Address - Zip Code:28016-7610
Practice Address - Country:US
Practice Address - Phone:704-616-4838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36278615390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program