Provider Demographics
NPI:1700864618
Name:SCHERLE, GREGORY ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALLEN
Last Name:SCHERLE
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:PO BOX 9999
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-0090
Mailing Address - Country:US
Mailing Address - Phone:734-439-1511
Mailing Address - Fax:
Practice Address - Street 1:4004 ARKONA ROAD
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160
Practice Address - Country:US
Practice Address - Phone:734-439-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036 603101207Q00000X
MDD0080292207Q00000X
MI4301109019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD516927YWV2Medicare PIN
MD517005YVZMedicare UPIN
MD517005ZDDBMedicare PIN