Individual
DR. REENA MEGHAN UNDERINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1013969
MA
207P00000X
Emergency Medicine Physician
Primary
84086
WI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
1013969
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100284807
—
WI
Enumeration date
04/13/2020
Last updated
10/30/2024
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