Healthcare Provider Details

I. General information

NPI: 1508614587
Provider Name (Legal Business Name): ULAS YALIM UNCU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF RADIOLOGY 420 DELAWARE ST SE MMC 292
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

DEPARTMENT OF RADIOLOGY 420 DELAWARE ST SE MMC 292
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-626-3345
  • Fax:
Mailing address:
  • Phone: 612-626-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number81220
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: