Provider Demographics
NPI:1104057454
Name:AL BACKER, TURKI B (MD)
Entity type:Individual
Prefix:DR
First Name:TURKI
Middle Name:B
Last Name:AL BACKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 EUCLID AVENUE
Mailing Address - Street 2:J 4- 133 E
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195
Mailing Address - Country:US
Mailing Address - Phone:216-445-6816
Mailing Address - Fax:216-636-1286
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:J4-133E
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-6816
Practice Address - Fax:216-636-1286
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-090891208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2970414Medicaid