Healthcare Provider Details

I. General information

NPI: 1093446247
Provider Name (Legal Business Name): FATMA BETUL YILMAZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date: 12/16/2025
Reactivation Date: 01/06/2026

III. Provider practice location address

5501 OLD YORK RD STE 1
PHILADELPHIA PA
19141-3098
US

IV. Provider business mailing address

5501 OLD YORK RD STE 1
PHILADELPHIA PA
19141-3098
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-6015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT227212
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: