Provider Demographics
NPI:1740293349
Name:RAJKUMAR JOSHI MD PLLC
Entity type:Organization
Organization Name:RAJKUMAR JOSHI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-883-8262
Mailing Address - Street 1:276 OLD MOCKSVILLE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8506
Mailing Address - Country:US
Mailing Address - Phone:704-883-8262
Mailing Address - Fax:704-883-8252
Practice Address - Street 1:276 OLD MOCKSVILLE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8506
Practice Address - Country:US
Practice Address - Phone:704-883-8262
Practice Address - Fax:704-883-8252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherALL COMERCIAL PAYOR
2348940Medicare ID - Type Unspecified
=========OtherALL COMERCIAL PAYOR