Provider Demographics
NPI:1588873640
Name:KARCH, JOSEPH (MD, PHD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KARCH
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 ST FRANCIS BLVD
Mailing Address - Street 2:SUITE 511
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3222
Mailing Address - Country:US
Mailing Address - Phone:804-423-8467
Mailing Address - Fax:804-726-1539
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 511
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-423-8467
Practice Address - Fax:804-726-1539
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007012462208600000X
VA0116014571390200000X
VA0101241382208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204456107Medicaid
VAC06695OtherGROUP PTAN
MO204456107Medicaid
VAC06695OtherGROUP PTAN
VACO301513Medicare PIN