Provider Demographics
NPI:1710947460
Name:JOSHI, KAUSTUBH GIRISH (MD)
Entity Type:Individual
Prefix:
First Name:KAUSTUBH
Middle Name:GIRISH
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3555 HARDEN ST EXT
Mailing Address - Street 2:15 MEDICAL PARK SUITE 141
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6894
Mailing Address - Country:US
Mailing Address - Phone:803-545-5017
Mailing Address - Fax:803-255-3455
Practice Address - Street 1:3555 HARDEN STREET EXT STE 301
Practice Address - Street 2:UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6894
Practice Address - Country:US
Practice Address - Phone:803-434-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-26
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCMD270172084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry