Provider Demographics
NPI:1740203900
Name:CHOITHANI, ASHOK C (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:C
Last Name:CHOITHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 N HONEY CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3189
Mailing Address - Country:US
Mailing Address - Phone:414-615-5900
Mailing Address - Fax:414-615-5927
Practice Address - Street 1:1155 N HONEY CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213
Practice Address - Country:US
Practice Address - Phone:414-615-5900
Practice Address - Fax:414-615-5927
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30830208M00000X
WI30830-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31582800Medicaid
WIP00259487OtherMEDICARE RAILROAD
WIP00259487OtherMEDICARE RAILROAD
WI0132-68655Medicare ID - Type Unspecified