Provider Demographics
NPI:1932498276
Name:JOSEPH, SHRUTI ROY (MD)
Entity Type:Individual
Prefix:
First Name:SHRUTI
Middle Name:ROY
Last Name:JOSEPH
Suffix:
Gender:F
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:ADVENTIST HEALTH TULARE - FAMILY MEDICINE RESIDENCY
Mailing Address - Street 2:2651 HIGHLAND AVE
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93724
Mailing Address - Country:US
Mailing Address - Phone:559-605-0090
Mailing Address - Fax:
Practice Address - Street 1:ADVENTIST HEALTH TULARE - FAMILY MEDICINE RESIDENCY
Practice Address - Street 2:2059 N HILLMAN ST
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93724
Practice Address - Country:US
Practice Address - Phone:559-605-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine