Individual
DR. PHAEDRA MARIA TACHTATZIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3310
(414) 805-3885
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3310
(414) 805-3885
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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