Provider Demographics
NPI:1356674246
Name:ALTINYAY, MUSTAFA ERKAN (MD)
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:ERKAN
Last Name:ALTINYAY
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 1:4475 W PINE BLVD APT 1701
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2326
Mailing Address - Country:US
Mailing Address - Phone:314-495-7326
Mailing Address - Fax:
Practice Address - Street 1:1402 S GRAND BLVD
Practice Address - Street 2:ST LOUIS UNIV SCH OF MED NUCLEAR MED PGM
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104
Practice Address - Country:US
Practice Address - Phone:314-268-8163
Practice Address - Fax:314-268-5144
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program