Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2004010999 | MO |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD432285 | PA |
NPI | 1154536407 |
---|---|
Provider Name | Dr. Ahmet Tayfun Gurbuz |
First Address | Williamsport, PA 17701-1900 |
Second Address | Saint Louis, MO 63117-1223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019749500001 | (05) | PA |
1905820 | UNITEDHEALTHCARE (01) | PA |
1978618 | HIGHMARK BLUE SHIELD (01) | PA |
7668165 | AETNA (01) | PA |
821787 | FIRST PRIORITY HEALTH (01) | PA |
G21079 | (02) | AZ |