Individual
REBECCA GAYLE MARTINIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4855 S MOORLAND RD FL 3, NEW BERLIN, WI 53151-7494
(262) 432-7599
(262) 432-7694
Mailing address
CHILDREN'S URGENT CARE, 9000 W WISCONSIN AVENUE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
71893-20
WI
208000000X
Pediatrics Physician
Q4630
TX
2080S0010X
Pediatric Sports Medicine Physician
Q4630
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700144698
—
WI
Enumeration date
04/27/2012
Last updated
10/11/2019
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