Provider Demographics
NPI:1184690711
Name:ERGIN, SUKRAN (MD)
Entity type:Individual
Prefix:DR
First Name:SUKRAN
Middle Name:
Last Name:ERGIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUKRAN
Other - Middle Name:
Other - Last Name:ERGIN-YANMAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11 NEVINS ST STE 401
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-787-5111
Mailing Address - Fax:617-787-5150
Practice Address - Street 1:11 NEVINS ST STE 401
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-787-5111
Practice Address - Fax:617-787-5150
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230366207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013760110001Medicaid
PA092433E8JMedicare ID - Type Unspecified
PA1013760110001Medicaid