Provider Demographics
NPI:1104896562
Name:DEPPE, GUNTER (MD)
Entity type:Individual
Prefix:
First Name:GUNTER
Middle Name:
Last Name:DEPPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400-CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:313-966-9777
Mailing Address - Fax:313-966-9767
Practice Address - Street 1:6011 WEST OUTER DRIVE SUITE 445
Practice Address - Street 2:SINAI GRACE POB
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-9777
Practice Address - Fax:313-966-9767
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046383207V00000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology