Provider Demographics
NPI:1104865575
Name:JOSHI, NOMITA (MD)
Entity Type:Individual
Prefix:
First Name:NOMITA
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 GUESS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4155
Mailing Address - Country:US
Mailing Address - Phone:864-233-2744
Mailing Address - Fax:864-233-7359
Practice Address - Street 1:213 E BUTLER ROAD
Practice Address - Street 2:BUILDING C-1
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2172
Practice Address - Country:US
Practice Address - Phone:864-284-0211
Practice Address - Fax:864-284-0266
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2012-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC17799207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571107258001OtherBCBS SC
SC571107258002OtherBLUE CHOICE SC
SC177999Medicaid
SC571107258002OtherBLUE CHOICE SC
G07328Medicare UPIN