Provider Demographics
NPI:1073054227
Name:JABLONSKI, MEGAN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:MOHNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9000 W WISCONSIN AVENUE
Mailing Address - Street 2:PEDIATRIC ANESTHESIOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-3560
Mailing Address - Fax:414-266-6092
Practice Address - Street 1:9000 W WISCONSIN AVENUE
Practice Address - Street 2:PEDIATRIC ANESTHESIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-3560
Practice Address - Fax:414-266-6092
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI76883207LP3000X
MA281830207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1073054227Medicaid