Provider Demographics
NPI:1770793424
Name:GAEBLER-UHING, CHARLENE L (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:L
Last Name:GAEBLER-UHING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHARLIE
Other - Middle Name:L
Other - Last Name:GAEBLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3365 S 103RD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53227-4108
Mailing Address - Country:US
Mailing Address - Phone:262-814-7080
Mailing Address - Fax:262-432-9004
Practice Address - Street 1:3365 S 103RD ST STE 210
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53227-4108
Practice Address - Country:US
Practice Address - Phone:262-814-7080
Practice Address - Fax:262-432-9004
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44220208000000X
WI44220-202080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34176800Medicaid
WI1770793424Medicaid
WI1770793424Medicaid
WI1770793424Medicaid
WI34176800Medicaid