Healthcare Provider Details

I. General information

NPI: 1700864618
Provider Name (Legal Business Name): GREGORY ALLEN SCHERLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 ARKONA ROAD
MILAN MI
48160
US

IV. Provider business mailing address

PO BOX 9999
MILAN MI
48160-0090
US

V. Phone/Fax

Practice location:
  • Phone: 734-439-1511
  • Fax:
Mailing address:
  • Phone: 734-439-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036 603101
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0080292
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301109019
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: