Powell Mattioli, Kathleen Mary

Powell Mattioli, Kathleen Mary is an individual health care provider with primary practice located at 8905 W Lincoln Ave Suite 501, West Allis WI 53227-2468. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Powell Mattioli, Kathleen Mary can be contacted via phone (414) 978-2229.

Contact Information

Primary practice address
8905 W Lincoln Ave Suite 501 West Allis WI 53227-2468
Phone: (414) 978-2229
Fax: (414) 978-2279
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 49339 Wisconsin
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036-163299 Illinois

Profile Details

NPI number 1457530446
LBN Legal business name Powell Mattioli, Kathleen Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2007
Last updated Jun 7th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457530446 NPPES
Wisconsin MEDICAID 35336200

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