Provider Demographics
NPI:1073834735
Name:JOSEPH, BIJI B (MD)
Entity type:Individual
Prefix:DR
First Name:BIJI
Middle Name:B
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BIJI
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6148 106 TH AVE.
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7599
Mailing Address - Country:US
Mailing Address - Phone:262-344-4803
Mailing Address - Fax:
Practice Address - Street 1:6148 106TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7599
Practice Address - Country:US
Practice Address - Phone:262-344-4803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53600- 020208D00000X
WI53600-0200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice