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Individual

HARDIK A VASHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7401 104TH AVE, SUITE 110, KENOSHA, WI 53142-7845
(262) 764-5595
(262) 764-9314
Mailing address
7401 104TH AVE, SUITE 110, KENOSHA, WI 53142-7845
(262) 764-5595
(262) 764-9314

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
45727
WI
208VP0014X
Interventional Pain Medicine Physician
Primary
45727
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43506000
WI
Enumeration date
11/08/2005
Last updated
05/25/2017
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