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General NPI Number Information
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NPI Number | 1750916540
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Entity Type | Individual
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Provider Name | AYSE BULAN
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 555 S 18TH ST
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City | COLUMBUS
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State | OH
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Zip | 43205-2654
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Country | US
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Telephone | 614-722-4322
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Fax |
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Provider Business Mailing Address
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Address Line | 22775 RENFORD ST
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City | NOVI
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State | MI
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Zip | 48375-4528
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Country | US
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Telephone | 585-434-6858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 57.248683
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License Number State | OH
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