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General NPI Number Information
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NPI Number | 1104087584
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Entity Type | Individual
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Provider Name | JENNIFER L BEPPLE MD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 10710 CHARTER DR. SUITE 130
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City | COLUMBIA
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State | MD
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Zip | 21044-3128
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Country | US
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Telephone | 410-772-7000
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Fax | 410-772-7089
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Provider Business Mailing Address
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Address Line | 25 CROSSROADS DRVIE SUITE 306
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City | OWINGS MILLS
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State | MD
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Zip | 21117
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Country | US
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Telephone | 443-738-2872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | D0069291
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 1026692
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License Number State | MD
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