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NPI Code Detail

MEDICARE: ANNIE M. KONTOS, P.C.

MEDICARE: ANNIE M. KONTOS, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician02475IA

General Provider Information

NPI Number : 1528248861
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANNIE M. KONTOS, P.C.
Provider Business Mailing Address
First Line : 305 E SAN MARNAN DR
Second Line :
City : WATERLOO
State : IA
Zip : 50702-5837
Country : US
Telephone Number : 319-235-3158
Fax Number :
Provider Business Practice Location Address
First Line : 305 E SAN MARNAN DR
Second Line :
City : WATERLOO
State : IA
Zip : 50702-5837
Country : US
Telephone Number : 319-235-3158
Fax Number :
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : DR. ANNIE MARIA KONTOS
Credential : D.O.
Telephone Number : 319-235-3158
Provider Enumeration Date : 11/04/2007
Last Update Date : 02/02/2009

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