Healthcare Provider Details

I. General information

NPI: 1447280631
Provider Name (Legal Business Name): GEROLD BEPLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 JOHN R KARMANOS CANCER CENTER
DETROIT MI
48201-2013
US

IV. Provider business mailing address

1560 E. MAPLE RD. SUITE 400-CREDENTIALING
TROY MI
48083
US

V. Phone/Fax

Practice location:
  • Phone: 800-527-6266
  • Fax: 313-576-8767
Mailing address:
  • Phone: 800-527-6266
  • Fax: 313-576-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME86830
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number4301097639
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: