Healthcare Provider Details

I. General information

NPI: 1346225877
Provider Name (Legal Business Name): CHANDRA S. JOSHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ALEXANDRA WAY
ACTON MA
01720-4171
US

IV. Provider business mailing address

41 MALL RD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 978-263-5331
  • Fax:
Mailing address:
  • Phone: 781-744-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number157451
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number157451
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: