Provider Demographics
NPI:1184624595
Name:JOSHOWITZ, JEFFREY (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:JOSHOWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:248-585-8216
Mailing Address - Fax:248-585-8266
Practice Address - Street 1:39475 LEWIS DR
Practice Address - Street 2:SUITE 140
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2952
Practice Address - Country:US
Practice Address - Phone:248-489-0766
Practice Address - Fax:248-489-0788
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4675316Medicaid
F02039Medicare UPIN
MI4675316Medicaid