Provider Demographics
NPI:1003875980
Name:SCHOEPPNER, GABRIELLE (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:SCHOEPPNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 NAZARETH RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8338
Mailing Address - Country:US
Mailing Address - Phone:610-258-7255
Mailing Address - Fax:610-258-5197
Practice Address - Street 1:3735 NAZARETH RD
Practice Address - Street 2:SUITE 205
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:610-258-7255
Practice Address - Fax:610-258-5197
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042419E207WX0009X, 207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232565428OtherUNITED HEALTHCARE
PA03120301OtherCAPITAL BLUE CROSS
PA3991556OtherCIGNA
PA180007320OtherRAILROAD MEDICARE
PA2645590OtherAETNA
PA505137OtherHIGHMARK BLUE SHIELD
PA1196431Medicaid
PA232565428OtherUNITED HEALTHCARE
PAE21995Medicare UPIN
PA1196431Medicaid
PA505137Medicare PIN