Healthcare Provider Details

I. General information

NPI: 1689170912
Provider Name (Legal Business Name): ANAND JOSHI MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 CANTERWOOD DR
WILMINGTON NC
28401-7300
US

IV. Provider business mailing address

504 ROSEWOOD DR
HARRISBURG SD
57032-2087
US

V. Phone/Fax

Practice location:
  • Phone: 910-763-2409
  • Fax:
Mailing address:
  • Phone: 980-581-5337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANAND JOSHI
Title or Position: DOCTOR
Credential: MD
Phone: 980-581-5337