Basic Information
| Provider Information | |||||||||
| NPI: | 1598893711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANDAU | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 N CHURCH ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274011038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3363752300 | ||||||||
| FaxNumber: | 3363752313 | ||||||||
| Practice Location | |||||||||
| Address1: | 1130 N CHURCH ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274011038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3363752300 | ||||||||
| FaxNumber: | 3363752313 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 02/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A85722 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 2008-00498 | NC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | RHC164955 | 01 | CA | FLUOROSCOPY XRAY | OTHER | A85722 | 01 | CA | CA LICENSE | OTHER | 2008-00498 | 01 | NC | NC MEDICAL LICENSE | OTHER | BL8677950 | 01 | CA | DEA LICENSE | OTHER |