Provider Demographics
NPI:1932624988
Name:JOSHI, ANAND
Entity Type:Individual
Prefix:
First Name:ANAND
Middle Name:
Last Name:JOSHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 HAWKSMOORE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-3628
Mailing Address - Country:US
Mailing Address - Phone:248-224-9772
Mailing Address - Fax:
Practice Address - Street 1:30521 SCHOENHERR RD STE 100
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3161
Practice Address - Country:US
Practice Address - Phone:586-619-9390
Practice Address - Fax:586-619-9380
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist