Individual
DR. PANAYOTIS FASSEAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF CARDIOVASCULAR MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6633
(414) 805-6280
Mailing address
9200 W WISCONSIN AVE, DIVISION OF CARDIOVASCULAR MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6633
(414) 805-6280
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
44746
WI
207RI0011X
Interventional Cardiology Physician
Primary
44746
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007000261W
HUMANA
—
01
—
028668480
MEDICARE PTAN
WI
01
—
032973840
MEDICARE PTAN
WI
05
—
1407800709
—
WI
Enumeration date
05/20/2006
Last updated
09/25/2017
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