Provider Demographics
NPI:1134923030
Name:BIJI JOSEPH MD S C
Entity type:Organization
Organization Name:BIJI JOSEPH MD S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN- OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BIJI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-344-4803
Mailing Address - Street 1:6935 70TH CT UNIT 106
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-1465
Mailing Address - Country:US
Mailing Address - Phone:262-344-4803
Mailing Address - Fax:
Practice Address - Street 1:6935 70TH CT UNIT 106
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-1465
Practice Address - Country:US
Practice Address - Phone:262-344-4803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty