Provider Demographics
NPI:1477516557
Name:ISMAILOGLU, MEHMET (MD)
Entity Type:Individual
Prefix:
First Name:MEHMET
Middle Name:
Last Name:ISMAILOGLU
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 1:614 JENNINGS LNDG
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3528
Mailing Address - Country:US
Mailing Address - Phone:269-274-3142
Mailing Address - Fax:
Practice Address - Street 1:614 JENNINGS LNDG
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3528
Practice Address - Country:US
Practice Address - Phone:269-274-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056504207R00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0004626216OtherAETNA
MI1101304082OtherBCBS
MI3336390Medicaid
MI0130408Medicare ID - Type Unspecified
MI0004626216OtherAETNA