Provider Demographics
NPI:1548235666
Name:JOSHI, SUBASH J (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBASH
Middle Name:J
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 503632
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:314-432-2580
Mailing Address - Fax:314-432-0223
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:SUITE 105N
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-355-0811
Practice Address - Fax:314-355-2669
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9381174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101154OtherHEALTHLINK
MO17457OtherBLUE CROSS BLUE SHIELD
MO3100011OtherUNITED HEALTH CARE
MO65392OtherGHP
MO65392OtherGHP