Healthcare Provider Details

I. General information

NPI: 1093776874
Provider Name (Legal Business Name): EUGENE H KAJI MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 DUNMORE ST
FITCHBURG WI
53711-6942
US

IV. Provider business mailing address

3008 DUNMORE ST
FITCHBURG WI
53711-6942
US

V. Phone/Fax

Practice location:
  • Phone: 608-442-8947
  • Fax: 608-264-4646
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number43838
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number43838
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: