Provider Demographics
NPI:1558305615
Name:JOSHI, PRAJWOL (MD)
Entity Type:Individual
Prefix:
First Name:PRAJWOL
Middle Name:
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 2879
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23058-2879
Mailing Address - Country:US
Mailing Address - Phone:804-672-8222
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2879
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23058-2879
Practice Address - Country:US
Practice Address - Phone:804-672-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239353207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4600290Medicaid
VAVV15039863Medicare PIN
VA4600290Medicaid
VAG99717Medicare UPIN