Healthcare Provider Details

I. General information

NPI: 1871772996
Provider Name (Legal Business Name): ASHWINKUMAR J JOSHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ARNOLD MALL
ARNOLD MO
63010-2223
US

IV. Provider business mailing address

10 ARNOLD MALL
ARNOLD MO
63010-2223
US

V. Phone/Fax

Practice location:
  • Phone: 636-296-3447
  • Fax:
Mailing address:
  • Phone: 636-296-3447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMDR8P01
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: