Provider Demographics
NPI:1831298223
Name:JOSEPH, ANTHONY L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:L
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1435 N MILFORD RD
Mailing Address - Street 2:STE 101
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1015
Mailing Address - Country:US
Mailing Address - Phone:248-345-9914
Mailing Address - Fax:248-684-2251
Practice Address - Street 1:414 UNION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1987
Practice Address - Country:US
Practice Address - Phone:248-684-7063
Practice Address - Fax:248-684-2251
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301051208600000X
ORMD211949208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3342824Medicaid
MI0635093Medicare ID - Type Unspecified
MI3342824Medicaid