Healthcare Provider Details

I. General information

NPI: 1225062334
Provider Name (Legal Business Name): GUNSEL ACIKGOZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GUNSEL VURAL

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/07/2023
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

IV. Provider business mailing address

3900 WOODLAND AVE
PHILADELPHIA PA
19104-4551
US

V. Phone/Fax

Practice location:
  • Phone: 215-823-5800
  • Fax:
Mailing address:
  • Phone: 215-823-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberC10007745
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberMD427439
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMD427439
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberC10007745
License Number StateDE
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD427439
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: