Provider Demographics
NPI:1396322186
Name:WHEATLEY, JOSHUA FARAAD (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:FARAAD
Last Name:WHEATLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1656 RIVERCHASE BLVD STE 2400
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-0271
Mailing Address - Country:US
Mailing Address - Phone:803-329-5131
Mailing Address - Fax:
Practice Address - Street 1:1656 RIVERCHASE BLVD STE 2400
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-0271
Practice Address - Country:US
Practice Address - Phone:803-329-5131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine