Provider Demographics
NPI:1548219678
Name:ERGUN, HULUSI (MD)
Entity Type:Individual
Prefix:MR
First Name:HULUSI
Middle Name:
Last Name:ERGUN
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 1:3605 WARRENSVILLE CTR RD
Mailing Address - Street 2:MSC9152
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-286-6299
Mailing Address - Fax:216-286-6341
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350444182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4676662OtherAETNA
OH000000545398OtherANTHEM
OHP00412321OtherRAILROAD MEDICARE
OH000000229277OtherUNISON
OH421780OtherWELLCARE
OH0488897Medicaid
OH0304914OtherBCMH
OHER0509955OtherPIN
OH751482OtherBUCKEYE
OH000000545398OtherANTHEM
OHER0509955OtherPIN