Provider Demographics
NPI:1497184766
Name:XENON ANESTHESIA OF MICHIGAN PLLC
Entity Type:Organization
Organization Name:XENON ANESTHESIA OF MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-621-6854
Mailing Address - Street 1:111 TOWN SQUARE PL STE 420
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1724
Mailing Address - Country:US
Mailing Address - Phone:917-397-1229
Mailing Address - Fax:201-604-6561
Practice Address - Street 1:220 W CONGRESS ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3289
Practice Address - Country:US
Practice Address - Phone:917-397-1229
Practice Address - Fax:201-604-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301099820207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty