Provider Demographics
NPI:1871049072
Name:CHATZIZACHARIAS, NIKOLAOS (MD, PHD, FRCS)
Entity type:Individual
Prefix:DR
First Name:NIKOLAOS
Middle Name:
Last Name:CHATZIZACHARIAS
Suffix:
Gender:M
Credentials:MD, PHD, FRCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 WEST WISCONSIN AVENUE
Mailing Address - Street 2:MEDICAL COLLEGE OF WISONSIN
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3596
Mailing Address - Country:US
Mailing Address - Phone:414-805-5020
Mailing Address - Fax:
Practice Address - Street 1:9200 WEST WISCONSIN AVENUE
Practice Address - Street 2:MEDICAL COLLEGE OF WISONSIN
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3596
Practice Address - Country:US
Practice Address - Phone:414-805-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65018-202086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology