Provider Demographics
NPI:1699869438
Name:JOSHUA, ALEXA (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:
Last Name:JOSHUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27209 LAHSER
Mailing Address - Street 2:SUITE 128
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-8402
Mailing Address - Country:US
Mailing Address - Phone:248-353-0200
Mailing Address - Fax:248-353-1513
Practice Address - Street 1:27209 LAHSER
Practice Address - Street 2:SUITE 128
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-8402
Practice Address - Country:US
Practice Address - Phone:248-353-0200
Practice Address - Fax:248-353-1513
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406975207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI424129010Medicaid
MION14910Medicare PIN
MI424129010Medicaid