Individual provider Active NPI

Gunter Deppe, MD

  • Gynecologic Oncology Physician
  • Detroit, MI
National Provider Identifier
1104896562
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
4301046383 Issued in MI
Practice address
6011 West Outer Drive Suite 445
Sinai Grace Pob
Detroit, MI 48235
Phone
(313) 966-9777
Fax
(313) 966-9767
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301046383 MI
Gynecologic Oncology Physician 207VX0201X 4301046383 MI Primary

Addresses

Primary practice location

6011 West Outer Drive Suite 445
Sinai Grace Pob
Detroit, MI 48235

Mailing address

1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1138
Phone (313) 966-9777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060802000273 MI Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 7113930512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301046383MIMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Obstetrics & Gynecology CurrentSince Oct 1, 2006 Accepting new patients
University Physician Group CurrentSince Oct 1, 2006 Accepting new patients
University Women'S Care, Inc Obstetrics & Gynecology Past Accepting new patients
Harper Hutzel Hospital Past Accepting new patients

Locations

3990 John R St
Ofc
Detroit, MI 48201

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

9230 Joseph Campau St
Hamtramck, MI 48212
Phone (313) 875-9270

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

28800 Ryan Rd
Ste 340
Warren, MI 48092

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1104896562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-966-9777",
            "fax_number": "313-966-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 WEST OUTER DRIVE SUITE 445",
            "address_2": "SINAI GRACE POB",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-966-9777",
            "fax_number": "313-966-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPPE",
        "first_name": "GUNTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301046383",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MI",
            "license": "4301046383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.