Provider Demographics
NPI:1639198740
Name:UHLER, TARA A (MD)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:A
Last Name:UHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WALNUT ST STE 800
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-440-3170
Mailing Address - Fax:215-825-4732
Practice Address - Street 1:840 WALNUT ST STE 800
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-440-3170
Practice Address - Fax:215-825-4732
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417118207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABU8443614OtherDEA
PAMD417118OtherLICENSE
PA0019726490001Medicaid
PAMD417118OtherLICENSE
PA0019726490001Medicaid