Provider Demographics
NPI:1821192949
Name:ERGUL, SITKI M (MD)
Entity Type:Individual
Prefix:
First Name:SITKI
Middle Name:M
Last Name:ERGUL
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 1:111 MIRACLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801
Mailing Address - Country:US
Mailing Address - Phone:803-641-7850
Mailing Address - Fax:803-643-0556
Practice Address - Street 1:111 MIRACLE DRIVE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801
Practice Address - Country:US
Practice Address - Phone:803-641-7850
Practice Address - Fax:803-643-0556
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19922207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC199225Medicaid
H469117139Medicare ID - Type Unspecified
SC199225Medicaid