Healthcare Provider Details

I. General information

NPI: 1417529157
Provider Name (Legal Business Name): UGUR BERKAY BALKANCI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date: 12/19/2022
Reactivation Date: 12/23/2022

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-5051
  • Fax:
Mailing address:
  • Phone: 202-476-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD500002868
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: