Individual
PHENU V ZACHARIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1151 WARWICK WAY, RACINE, WI 53406-5661
(262) 321-6300
(262) 321-6301
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
2010020902
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
70454
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100084384
—
WI
05
—
1598759169
—
MO
01
—
P00866350
RR MEDICARE
MO
Enumeration date
09/04/2007
Last updated
01/21/2025
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