Provider Demographics
NPI:1619258530
Name:ALTUN, ERSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ERSAN
Middle Name:
Last Name:ALTUN
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:ALI NIHAT TARLAN CAD. OGRT SIT. NO:50/5 B BLOK
Mailing Address - Street 2:BOSTANCI KADIKOY
Mailing Address - City:ISTANBUL
Mailing Address - State:ISTANBUL
Mailing Address - Zip Code:34744
Mailing Address - Country:TR
Mailing Address - Phone:90216-574-0934
Mailing Address - Fax:
Practice Address - Street 1:ACIBADEM KOZYATAGI HASTANESI
Practice Address - Street 2:KOZYATAGI KADIKOY
Practice Address - City:ISTANBUL
Practice Address - State:ISTANBUL
Practice Address - Zip Code:34742
Practice Address - Country:TR
Practice Address - Phone:90216-571-4319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ65364-976432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology