Healthcare Provider Details

I. General information

NPI: 1538571344
Provider Name (Legal Business Name): ALLISON NICOLE UBER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLIE UBER MD

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 RUTLEDGE AVE
CHARLESTON SC
29425-8903
US

IV. Provider business mailing address

135 RUTLEDGE AVE
CHARLESTON SC
29425
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number60614
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: