Individual
DR. MRIDANI CHOUDHURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8130
(715) 732-8131
Mailing address
PO BOX 18, MARINETTE, WI 54143-0018
(715) 732-7286
(715) 735-4616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301097036
MI
207Q00000X
Family Medicine Physician
Primary
60009-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275847519
—
MI
05
—
1275847519
—
WI
Enumeration date
07/28/2010
Last updated
11/30/2021
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