Provider Demographics
NPI:1851106801
Name:VAN DER EERDEN, JOSHUA HENRI
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:HENRI
Last Name:VAN DER EERDEN
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 1:2832 DOVER RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1273
Mailing Address - Country:US
Mailing Address - Phone:404-889-4928
Mailing Address - Fax:
Practice Address - Street 1:2832 DOVER RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1273
Practice Address - Country:US
Practice Address - Phone:404-889-4928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program