Healthcare Provider Details

I. General information

NPI: 1629171699
Provider Name (Legal Business Name): PUSHPA NAMBI JOSEPH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 W HIGH ST STE 160
LIMA OH
45801-5900
US

IV. Provider business mailing address

770 W HIGH ST STE 160
LIMA OH
45801-5900
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5224
  • Fax: 419-996-5276
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number24510
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number24655
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number24655
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35.081683
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: