Healthcare Provider Details

I. General information

NPI: 1124003579
Provider Name (Legal Business Name): MEHMET TAMER YALCINKAYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 FORRESTGATE DR
WINSTON SALEM NC
27103-2930
US

IV. Provider business mailing address

PO BOX 25804
WINSTON SALEM NC
27114-5804
US

V. Phone/Fax

Practice location:
  • Phone: 336-448-9100
  • Fax: 336-778-7995
Mailing address:
  • Phone: 336-448-9100
  • Fax: 336-778-7995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number200500326
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number200500326
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: