Tachtatzis, Phaedra Maria

Tachtatzis, Phaedra Maria is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Transplant Hepatology, Allopathic & Osteopathic Physicians / Hepatology. Allopathic & Osteopathic Physicians / Hepatology is her primary health care specialty. Tachtatzis, Phaedra Maria can be contacted via phone (414) 805-3310.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 805-3310
Fax: (414) 805-3885
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Transplant Hepatology 207RT0003X 10-876 Wisconsin
Allopathic & Osteopathic Physicians / Hepatology 207RI0008X 10-876 Wisconsin

Profile Details

NPI number 1801672282
LBN Legal business name Tachtatzis, Phaedra Maria
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2023
Last updated Nov 17th, 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 1801672282 NPPES
Wisconsin MEDICAID 1801672282

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