Provider Demographics
NPI:1154536407
Name:GURBUZ, AHMET TAYFUN (MD)
Entity type:Individual
Prefix:DR
First Name:AHMET
Middle Name:TAYFUN
Last Name:GURBUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:844-832-1956
Mailing Address - Fax:989-633-5241
Practice Address - Street 1:2660 W SUGNET RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2647
Practice Address - Country:US
Practice Address - Phone:989-488-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432285208G00000X
MO2004010999208G00000X
MI4301111340208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1978618OtherHIGHMARK BLUE SHIELD
PA821787OtherFIRST PRIORITY HEALTH
PA1905820OtherUNITEDHEALTHCARE
PA7668165OtherAETNA
PA1019749500001Medicaid
PA114577Medicare PIN
PAP00453750Medicare PIN
PA1905820OtherUNITEDHEALTHCARE