Individual
JOSH J MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 LAKEVIEW DR, GOSHEN, IN 46528-9365
(574) 533-1234
Mailing address
330 LAKEVIEW DR, GOSHEN, IN 46528-9365
(574) 533-1234
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01061861A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200816960
—
IN
01
—
P00396654
RAILROAD MEDICARE PIN
IN
Enumeration date
06/15/2006
Last updated
08/08/2011
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