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Individual

DR. PHAEDRA MARIA TACHTATZIS

Active
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Individual

DR. PHAEDRA MARIA TACHTATZIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RI0008X
Hepatology Physician
Primary
10-876
WI
207RT0003X
Transplant Hepatology Physician
10-876
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801672282
WI
Enumeration date
09/01/2023
Last updated
11/17/2023
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