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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

Other

Enumeration date
03/16/2018
Last updated
03/16/2018
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