Provider Demographics
NPI:1861499741
Name:BASARAN, MEHMET (MD)
Entity Type:Individual
Prefix:
First Name:MEHMET
Middle Name:
Last Name:BASARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 MACKENZIE DR FL 2
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2967
Mailing Address - Country:US
Mailing Address - Phone:614-273-2250
Mailing Address - Fax:614-273-2255
Practice Address - Street 1:477 COOPER RD STE 480
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8095
Practice Address - Country:US
Practice Address - Phone:614-823-7135
Practice Address - Fax:614-823-7137
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056572B207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0699338Medicaid
OH069938Medicaid
OHA17583Medicare UPIN
OH030005181OtherRAILROAD MEDICARE