Provider Demographics
NPI:1609055771
Name:JOSHI, CHARUTA NARAYAN (MBBS)
Entity Type:Individual
Prefix:
First Name:CHARUTA
Middle Name:NARAYAN
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:CHARUTA
Other - Middle Name:ABHAY
Other - Last Name:DIVEKAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA374862084N0402X
CODR.00567822084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71371OtherWELLMARK BCBS
IAI21469Medicare PIN