Provider Demographics
NPI:1003970799
Name:AVCI-WOLF, GUNSEL FATIMA (DO)
Entity Type:Individual
Prefix:DR
First Name:GUNSEL
Middle Name:FATIMA
Last Name:AVCI-WOLF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1990 UNION LAKE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-2202
Mailing Address - Country:US
Mailing Address - Phone:248-363-7109
Mailing Address - Fax:248-363-7211
Practice Address - Street 1:1990 UNION LAKE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-2202
Practice Address - Country:US
Practice Address - Phone:248-363-7109
Practice Address - Fax:248-363-7211
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIGA012197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF70562Medicare UPIN