Provider Demographics
NPI:1376162693
Name:JOSHI, ATHARVA PRASHANT (MD)
Entity Type:Individual
Prefix:
First Name:ATHARVA
Middle Name:PRASHANT
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:PO BOX 2040
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-2040
Mailing Address - Country:US
Mailing Address - Phone:808-553-5038
Mailing Address - Fax:808-553-5194
Practice Address - Street 1:30 OKI PLACE
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-553-5038
Practice Address - Fax:808-553-5194
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT3309207Q00000X, 390200000X
HI23711207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program