Provider Demographics
NPI:1992797757
Name:JOSHI, CHANDRIKA (MD)
Entity type:Individual
Prefix:
First Name:CHANDRIKA
Middle Name:
Last Name:JOSHI
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 1:25500 MEADOWBROOK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1879
Mailing Address - Country:US
Mailing Address - Phone:248-465-4340
Mailing Address - Fax:248-465-4341
Practice Address - Street 1:25500 MEADOWBROOK RD STE 120
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1879
Practice Address - Country:US
Practice Address - Phone:248-465-4340
Practice Address - Fax:248-465-4341
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062607207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3143708OtherEFCMG
MI325375110Medicaid
MI4301062607OtherCONTROLLED SUBSTANCE
MI4301062607OtherCONTROLLED SUBSTANCE
MI325375110Medicaid