Choudhury, Mridani
Choudhury, Mridani is an individual health care provider with primary practice located at 4061 Old Peshtigo Rd , Marinette WI 54143-3887. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Choudhury, Mridani can be contacted via phone (715) 732-8130.Contact Information
Primary practice address
4061 Old Peshtigo Rd
Marinette WI 54143-3887
Phone: (715) 732-8130
Fax: (715) 732-8131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4301097036 | Michigan |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 60009-20 | Wisconsin |
Profile Details
| NPI number | 1275847519 |
|---|---|
| LBN Legal business name | Choudhury, Mridani |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2010 |
| Last updated | Nov 30th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275847519 | NPPES |
| Wisconsin | MEDICAID | 1275847519 | |
| Wisconsin | MEDICAID | 1275847519 |
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