Individual
DR. STEVEN MATHER KOTSONIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1109 CECELIA DR, PEWAUKEE, WI 53072-2524
(262) 373-6733
(262) 373-6018
Mailing address
12420 W HAMPTON AVE #89, BUTLER, WI 53007-0089
(262) 373-6733
(262) 373-6018
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
53437-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100031662
—
WI
Enumeration date
03/21/2008
Last updated
06/27/2018
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