Provider Demographics
NPI:1164719605
Name:JOSHI, SONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:JOSHI
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 1:1601 KIRTS BLVD
Mailing Address - Street 2:APT 201
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4318
Mailing Address - Country:US
Mailing Address - Phone:847-693-6192
Mailing Address - Fax:
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301099357208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics