Faithful Physician Services LLC

NPI #1467817320 in Pewaukee, Wisconsin

Provider Information

NPI Number: 1467817320
Entity Type: Organization
Organization Name: Faithful Physician Services LLC
Primary Specialty: Family Medicine
Enumeration Date: Dec 20, 2015
Last Updated: Jun 27, 2018

Practice Location

Address: 1109 CECELIA DRIVE
City: Pewaukee
State: Wisconsin
ZIP Code: 53072-2524
Phone: (262) 373-6733

Authorized Official

Name: DR. STEVEN MATHER KOTSONIS, M.D.
Title: OWNER
Phone: (262) 373-6733

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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