Provider Demographics
NPI:1063488104
Name:JOSHI, RAJ KUMAR (MD)
Entity Type:Individual
Prefix:MR
First Name:RAJ
Middle Name:KUMAR
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 OLD MOCKSVILLE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-1949
Mailing Address - Country:US
Mailing Address - Phone:704-883-8262
Mailing Address - Fax:704-883-8252
Practice Address - Street 1:276 OLD MOCKSVILLE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-1949
Practice Address - Country:US
Practice Address - Phone:704-883-8262
Practice Address - Fax:704-883-8252
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2009-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500378174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist