Provider Demographics
NPI:1114998986
Name:JOSHI, ANILKUMAR RAGHUNATH (MD)
Entity Type:Individual
Prefix:
First Name:ANILKUMAR
Middle Name:RAGHUNATH
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 1:2050 MEADOWVIEW PARKWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-7332
Mailing Address - Country:US
Mailing Address - Phone:423-230-5000
Mailing Address - Fax:423-230-5097
Practice Address - Street 1:295 WHARTON LANE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273
Practice Address - Country:US
Practice Address - Phone:276-679-0321
Practice Address - Fax:276-679-6498
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034579207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010359660Medicaid
VA006085423Medicaid
VA010359660Medicaid
VA017643W82Medicare PIN
VA110006210Medicare PIN
110006210Medicare PIN
VA110120190Medicare PIN
C47380Medicare UPIN