Provider Demographics
NPI:1215020227
Name:TURCIOS, BETTY G (MD)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:G
Last Name:TURCIOS
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 1:4805 LORAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102
Mailing Address - Country:US
Mailing Address - Phone:216-631-5749
Mailing Address - Fax:216-631-5870
Practice Address - Street 1:4805 LORAIN AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102
Practice Address - Country:US
Practice Address - Phone:216-631-5749
Practice Address - Fax:216-631-5870
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35040576207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0393837Medicaid
OH0459553Medicare PIN
OH0393837Medicaid