Provider Demographics
NPI:1528267952
Name:BAYRAKTAR, ULAS DARDA (MD)
Entity type:Individual
Prefix:
First Name:ULAS
Middle Name:DARDA
Last Name:BAYRAKTAR
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 1:3825 TEAYS VALLEY RD STE 5
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9614
Mailing Address - Country:US
Mailing Address - Phone:304-388-4949
Mailing Address - Fax:304-757-7566
Practice Address - Street 1:3825 TEAYS VALLEY RD STE 5
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9614
Practice Address - Country:US
Practice Address - Phone:304-388-4949
Practice Address - Fax:304-757-7566
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5563207RH0003X
WV28598207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CQ115OtherBCBS
TX215113601Medicaid
TXTXB107797Medicare PIN