Healthcare Provider Details

I. General information

NPI: 1457855488
Provider Name (Legal Business Name): MEMDUHA GUMUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

1400 PELHAM PKWY S
BRONX NY
10461-1197
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5525
  • Fax:
Mailing address:
  • Phone: 718-696-2583
  • Fax: 718-881-5074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD483997
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: