Provider Demographics
NPI:1699740290
Name:KAPLAN, DALE MARC (DPM)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:MARC
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 W SUNSET STRIP DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-8745
Mailing Address - Country:US
Mailing Address - Phone:248-931-0910
Mailing Address - Fax:866-258-9993
Practice Address - Street 1:882 W SUNSET STRIP DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-8745
Practice Address - Country:US
Practice Address - Phone:248-931-0910
Practice Address - Fax:866-258-9993
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDK00837213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540E018980OtherBCBS-DME
MI540E028410OtherBCBS
MI382380833OtherCOMMERCIAL
MI4855014280OtherBCBS
MI131355117Medicaid
MIDK000837OtherBCBS
MIT34412Medicare UPIN
MI131355117Medicaid
MI0882260001Medicare NSC