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Organization
PHOENIXC HEALTHCARE, SC
Active
Organization
PHOENIXC HEALTHCARE, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDRAJIT CHOUDHURI MD (PRESIDENT)
(708) 488-9515
Entity
Organization
Contact information
Practice address
6121 GREEN BAY RD STE 100, KENOSHA, WI 53142-2931
(708) 488-9515
Mailing address
11168 N LAKE SHORE DR, MEQUON, WI 53092-5811
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
NULL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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