Provider Demographics
NPI:1467715185
Name:JOSHUA, BOSEDE BAMIJOKO (MD)
Entity Type:Individual
Prefix:
First Name:BOSEDE
Middle Name:BAMIJOKO
Last Name:JOSHUA
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 1:4401 N CAMPUS RIDGE DR
Mailing Address - Street 2:STE D2100
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6112
Mailing Address - Country:US
Mailing Address - Phone:989-837-9300
Mailing Address - Fax:989-837-9307
Practice Address - Street 1:4401 CAMPUS RIDGE DR STE 2100
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6125
Practice Address - Country:US
Practice Address - Phone:989-837-9300
Practice Address - Fax:989-837-9307
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301101241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine