Basic Information
| Provider Information | |||||||||
| NPI: | 1114998986 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOSHI | ||||||||
| FirstName: | ANILKUMAR | ||||||||
| MiddleName: | RAGHUNATH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2050 MEADOWVIEW PARKWAY | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376607332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232305000 | ||||||||
| FaxNumber: | 4232305097 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 WHARTON LANE | ||||||||
| Address2: | |||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766790321 | ||||||||
| FaxNumber: | 2766796498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 06/28/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 0101034579 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 010359660 | 05 | VA | MEDICAID | 006085423 | 05 | VA | MEDICAID |