Provider Demographics
NPI:1245857861
Name:JOSHI, ABHIJEET S (MD)
Entity type:Individual
Prefix:DR
First Name:ABHIJEET
Middle Name:S
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:102 W KENWOOD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4379
Mailing Address - Country:US
Mailing Address - Phone:217-872-3800
Mailing Address - Fax:217-872-0849
Practice Address - Street 1:1718 E KESSLER BLVD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-1842
Practice Address - Country:US
Practice Address - Phone:360-747-5800
Practice Address - Fax:360-575-3846
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL12507551207Q00000X
WAMD61421301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine