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General NPI Number Information
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NPI Number | 1104896562
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Entity Type | Individual
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Provider Name | GUNTER DEPPE MD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 6011 WEST OUTER DRIVE SUITE 445 SINAI GRACE POB
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City | DETROIT
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State | MI
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Zip | 48235
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Country | US
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Telephone | 313-966-9777
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Fax | 313-966-9767
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Provider Business Mailing Address
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Address Line | 1560 E MAPLE RD SUITE 400-CREDENTIALING
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City | TROY
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State | MI
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Zip | 48083-1138
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Country | US
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Telephone | 313-966-9777
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Fax | 313-966-9767
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301046383
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 4301046383
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License Number State | MI
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