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Individual

SHAUN K JOSHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1986 W HAYDEN AVE, HAYDEN, ID 83835-7412
(208) 762-7760
(208) 762-7740
Mailing address
1986 W HAYDEN AVE, HAYDEN, ID 83835-7412
(208) 762-7760
(208) 762-7740

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
M-8219
ID
207RN0300X
Nephrology Physician
MD00037068
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11003291
MEDICARE PTAN
01
1370136
MEDICARE GROUP PTAN
05
7144785
WA
05
8058994
ID
05
8080036
ID
05
8239220
WA
Enumeration date
08/22/2006
Last updated
06/16/2021
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