Provider Demographics
NPI:1952938995
Name:ULUSAN, AHMETMURSEL (MD)
Entity Type:Individual
Prefix:
First Name:AHMETMURSEL
Middle Name:
Last Name:ULUSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AHMET
Other - Middle Name:MURSEL
Other - Last Name:ULUSAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2121 W HOLCOMBE BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3303
Mailing Address - Country:US
Mailing Address - Phone:713-677-7602
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-4154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX41625045OtherDRIVING LICENSE