Provider Demographics
NPI:1558335307
Name:UCER, MUSTAFA ORHAN (MD)
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:ORHAN
Last Name:UCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ORHAN
Other - Middle Name:
Other - Last Name:UCER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 PHALEN BLVD
Practice Address - Street 2:41102D
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-254-7670
Practice Address - Fax:651-254-7676
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN401852084N0400X, 2084S0012X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN169825700Medicaid
MN169825700Medicaid
MN130001154Medicare ID - Type Unspecified