Provider Demographics
NPI:1346234804
Name:HENDERSHOT, ASLIGUL CAKMAK (MD)
Entity Type:Individual
Prefix:
First Name:ASLIGUL
Middle Name:CAKMAK
Last Name:HENDERSHOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASLIGUL
Other - Middle Name:
Other - Last Name:CAKMAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15029 N THOMPSON PEAK PKWY
Mailing Address - Street 2:SUITE B111-508
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2217
Mailing Address - Country:US
Mailing Address - Phone:480-620-9081
Mailing Address - Fax:480-214-2545
Practice Address - Street 1:15029 N THOMPSON PEAK PKWY
Practice Address - Street 2:SUITE B111-508
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2217
Practice Address - Country:US
Practice Address - Phone:480-620-9081
Practice Address - Fax:480-214-2545
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ806672-01Medicaid
AZ806672-01Medicaid
AZG55708Medicare UPIN