1396723813 NPI number — DR. AHMET F DIRICAN MD

Table of content: DR. AHMET F DIRICAN MD (NPI 1396723813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396723813 NPI number — DR. AHMET F DIRICAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIRICAN
Provider First Name:
AHMET
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396723813
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
726 COUNTY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02740-5405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-984-5671
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
726 COUNTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-5405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-984-5671
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  155176 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000021641 . This is a "BMC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 004980 . This is a "SENIOR WHOLE HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22D1015178 . This is a "CLIA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J19903 . This is a "BLUE SHIELD BILLING ID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3176576 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00039394 . This is a "RAILROAD PALMETTO GBA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4130813 . This is a "CIGNA BILLING ID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 00-02362 . This is a "EVERCARE IP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 155176 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 04-46128 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000021641 . This is a "BMC HEALTHNET ID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000033480 . This is a "BMC HEALTHNET UNDER LLC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 68886 . This is a "HARVARD PILGRIM ID" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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