Provider Demographics
NPI:1417909490
Name:SUNGURLU, MEHMET AKIF (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHMET
Middle Name:AKIF
Last Name:SUNGURLU
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 1:2737 NAVARRE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3298
Mailing Address - Country:US
Mailing Address - Phone:419-691-5711
Mailing Address - Fax:419-691-0017
Practice Address - Street 1:2737 NAVARRE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3298
Practice Address - Country:US
Practice Address - Phone:419-691-5711
Practice Address - Fax:419-691-0017
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060770207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0816586Medicaid
OH0816586Medicaid
E21644Medicare UPIN