Individual
KATHLEEN MARY POWELL MATTIOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8905 W LINCOLN AVE, SUITE 501, WEST ALLIS, WI 53227-2468
(414) 978-2229
(414) 978-2279
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-163299
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
49339
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35336200
—
WI
Enumeration date
10/26/2007
Last updated
06/07/2023
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