Provider Demographics
NPI:1093725186
Name:DOSHI, USHA L (MD)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:L
Last Name:DOSHI
Suffix:
Gender:F
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:PO BOX 3160
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-0160
Mailing Address - Country:US
Mailing Address - Phone:313-925-4540
Mailing Address - Fax:313-925-0322
Practice Address - Street 1:3956 MOUNT ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-1841
Practice Address - Country:US
Practice Address - Phone:313-925-4540
Practice Address - Fax:313-925-0322
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301040412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104412119Medicaid
MI104412137Medicaid
MI104412128Medicaid
MI700H248710OtherBLUE CROSS GROUP NUMBER
MI104412137Medicaid
MI104412128Medicaid