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NPI Code Detail

MEDICARE: VISHAKHA RAVINDRA CHOUDHARI

MEDICARE: VISHAKHA RAVINDRA CHOUDHARI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6001581-15WI

General Provider Information

NPI Number : 1801639661
Entity Type Code : Individual
Provider Name (Legal Business Name) : VISHAKHA RAVINDRA CHOUDHARI
Provider Business Mailing Address
First Line : 2011 S HURON PKWY APT 7
Second Line :
City : ANN ARBOR
State : MI
Zip : 48104-4162
Country : US
Telephone Number : 734-680-3873
Fax Number :
Provider Business Practice Location Address
First Line : 5341 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-1365
Country : US
Telephone Number : 414-871-0827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 06/18/2024

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Directions to “ VISHAKHA RAVINDRA CHOUDHARI ” Practice Location

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