Provider Demographics
NPI:1609641612
Name:WINTERS, JOSHUA JAMES (MAC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 YORK BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4201
Mailing Address - Country:US
Mailing Address - Phone:314-518-9311
Mailing Address - Fax:
Practice Address - Street 1:397 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-1218
Practice Address - Country:US
Practice Address - Phone:508-734-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program