Healthcare Provider Details

I. General information

NPI: 1225068661
Provider Name (Legal Business Name): SUBHASH B JOSHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S LAKE PARK AVE
HOBART IN
46342-6638
US

IV. Provider business mailing address

9945 TWIN CREEK BLVD
MUNSTER IN
46321-4231
US

V. Phone/Fax

Practice location:
  • Phone: 219-947-6695
  • Fax: 219-947-6092
Mailing address:
  • Phone: 219-947-6695
  • Fax: 219-947-6092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01032162
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01032162
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: